Hormonal Aspects of Epilepsy

Pennell, Page B.

doi:10.1016/j.ncl.2009.08.005

Cited by 84 publications

(66 citation statements)

References 81 publications

(104 reference statements)

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“…Thyroid hormones have an important role in perinatal development of the central nervous system, and recent studies have reported that the incidence of seizure in people with hyperthyroidism is higher than in individuals with normal hormone levels. 17 Our data show that the frequency of seizure in CH patients was 2.7%. Although no study has shown a correlation between seizure and CH in newborns or children, a recent case report described an infant suffering from intractable neonatal seizures with CH.…”

Section: Discussionmentioning

confidence: 51%

Epidemiology and Clinical Characteristics of Congenital Hypothyroidism in an Asian Population: A Nationwide Population-Based Study

Lee

Lai

et al. 2013

Journal of Epidemiology

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BackgroundThe incidence of congenital hypothyroidism (CH) has been increasing in Western countries, and some populations, including Asians, have a higher incidence. Delayed diagnosis and early treatment influence the outcome of CH. We investigated the incidence and clinical characteristics of CH in Taiwan.MethodsIn this retrospective database study we identified cases of CH diagnosed during 1997–2008 in the Taiwan National Health Insurance Research Database (NHIRD). Patients who had a Serious Accidents and Diseases certificate were included in the incidence calculation. We focused on CH patients who were born during 1997–2003 and determined their age at diagnosis and CH-related clinical features. Mental retardation and physiological delays were evaluated with respect to age at diagnosis.ResultsA total of 1482 cases were identified. Incidence during the 12-year period was 5.02 per 10 000 births. Among 1115 patients, the most common clinical features of CH were developmental delay (9.6%), constipation (11.6%), and delayed physiological development (9.1%). Congenital anomalies of the heart (7.7%), epilepsy (2.7%), and infantile cerebral palsy (3.2%) were also noted. Survival analysis showed that the risks of mental retardation (hazard ratio [HR], 3.180) and delayed physiological development (HR, 1.908) were greater when age at diagnosis was greater than 1 year.ConclusionsCH incidence was higher in Taiwan than in Western countries. Early diagnosis may decrease the risk of mental and physiological delay.

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Section: Discussionmentioning

confidence: 51%

Epidemiology and Clinical Characteristics of Congenital Hypothyroidism in an Asian Population: A Nationwide Population-Based Study

Lee

Lai

et al. 2013

Journal of Epidemiology

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“…Finally, brain-derived neurotrophic factor (BDNF) enhances the expression of GS and the glutamate transporter GLAST in astrocytes (Dai et al, 2012). Because stress (Friis and Lund, 1974), estrous cycle hormones (Pennell, 2009), glucose metabolism (Garriga-Canut et al, 2006), and neuronal reorganization (Ben-Ari, 2008) have been implicated in the pathophysiology of seizures and epilepsy, it is possible that perturbations in these factors influence the expression of GS in MTLE. Whether and exactly how these factors regulate GS in MTLE remain to be established.…”

Section: Regulation Of Gs In Astrocytesmentioning

confidence: 99%

Regulation of astrocyte glutamine synthetase in epilepsy

Eid

Lee

et al. 2013

Neurochemistry International

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Astrocytes play a crucial role in regulating and maintaining the extracellular chemical milieu of the central nervous system under physiological conditions. Moreover, proliferation of phenotypically altered astrocytes (a.k.a. reactive astrogliosis) has been associated with many neurologic and psychiatric disorders, including mesial temporal lobe epilepsy (MTLE). Glutamine synthetase (GS), which is found in astrocytes, is the only enzyme known to date that is capable of converting glutamate and ammonia to glutamine in the mammalian brain. This reaction is important, because a continuous supply of glutamine is necessary for the synthesis of glutamate and GABA in neurons. The known stoichiometry of glutamate transport across the astrocyte plasma membrane also suggests that rapid metabolism of intracellular glutamate via GS is a prerequisite for efficient glutamate clearance from the extracellular space. Several studies have indicated that the activity of GS in astrocytes is diminished in several brain disorders, including MTLE. It has been hypothesized that the loss of GS activity in MTLE leads to increased extracellular glutamate concentrations and epileptic seizures. Understanding the mechanisms by which GS is regulated may lead to novel therapeutic approaches to MTLE, which is frequently refractory to antiepileptic drugs. This review discusses several known mechanisms by which GS expression and function are influenced, from transcriptional control to enzyme modification.

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“…Oxcarbazepine (OXC) and CBZ may be related to alterations in thyroxin and free thyroxin serum levels, but normal TSH levels. These abnormalities are not clinically significant [26].…”

Section: Carbamazepine and Oxcarbazepinementioning

confidence: 86%

“…Polycystic Ovary Syndrome It is important that clinicians consider the association of PCOS in women treated with VPA, as is associated with metabolic disorders (such as obesity, glucose intolerance, hyperinsulinaemia, and dyslipidaemia) and endometrial carcinoma in the long term [26]. PCOS should be monitored in women with VPA monotheraphy/polytherapy [84].…”

Section: Endocrinologicalmentioning

confidence: 99%

Management of Adverse Effects of Mood Stabilizers

Murru

Popović

Pacchiarotti

et al. 2015

Curr Psychiatry Rep

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Mood stabilizers such as lithium and anticonvulsants are still standard-of-care for the acute and long-term treatment of bipolar disorder (BD). This systematic review aimed to assess the prevalence of their adverse effects (AEs) and to provide recommendations on their clinical management. We performed a systematic research for studies reporting the prevalence of AEs with lithium, valproate, lamotrigine, and carbamazepine/oxcarbazepine. Management recommendations were then developed. Mood stabilizers have different tolerability profiles and are eventually associated to cognitive, dermatological, endocrine, gastrointestinal, immunological, metabolic, nephrogenic, neurologic, sexual, and teratogenic AEs. Most of those can be transient or dose-related and can be managed by optimizing drug doses to the lowest effective dose. Some rare AEs can be serious and potentially lethal, and require abrupt discontinuation of medication. Integrated medical attention is warranted for complex somatic AEs. Functional remediation and psychoeducation may help to promote awareness on BD and better medication management.

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Hormonal Aspects of Epilepsy

Cited by 84 publications

References 81 publications

Epidemiology and Clinical Characteristics of Congenital Hypothyroidism in an Asian Population: A Nationwide Population-Based Study

Epidemiology and Clinical Characteristics of Congenital Hypothyroidism in an Asian Population: A Nationwide Population-Based Study

Regulation of astrocyte glutamine synthetase in epilepsy

Management of Adverse Effects of Mood Stabilizers

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