Pituitary and Adrenal Function in Epileptic Patients

Abstract

ACTH and cortisol were measured simultaneously in plasma samples obtained every 5 min from subjects at two different diurnal times. In the first study adrenocorticotropic hormone (ACTH) mean concentration and secretory rate were elevated in anticonvulsant drug-treated temporal lobe epileptic patients in comparison to anticonvulsant drug-treated patients with pseudoseizures. Cortisol mean concentrations and secretory rate were similar in these groups of subjects. In the second study, mean ACTH concentration and secretory rate were higher in temporal lobe epileptic patients than in normal controls. Both measures of ACTH secretion were similar in post-temporal lobectomy patients and normal controls. Mean cortisol concentration and secretory rates were highest in the temporal lobe epileptic patients, lowest in normal controls, and intermediate in post-temporal lobectomy patients. We conclude that ACTH and cortisol secretion is abnormal in temporal lobe epileptic patients. Temporal lobectomy restores abnormal ACTH secretion to normal whether or not seizures are controlled. The absence of ACTH changes in the pseudoseizure patients suggests that these changes are not drug induced. Cortisol secretion is similar in temporal lobe epileptic patients and pseudoseizure patients, suggesting a direct effect of the drugs upon the adrenal cortex.

Hormon- und Sexualstörungen bei Epilepsie

“…Psychosozialer Stress kann bei Hypogonadismus in Verbindung mit einer Epilepsie eine wichtige Rolle spielen [45][46][47][48][49][50]. Aus der neuroendokrinen Perspektive involviert eine Stressantwort die Aktivierung der hypothalamisch-hypophysären (HPA) Achse [6,[46][47][48][49][50].…”

“…Aus der neuroendokrinen Perspektive involviert eine Stressantwort die Aktivierung der hypothalamisch-hypophysären (HPA) Achse [6,[46][47][48][49][50]. Cortisolspiegel sind bei Menschen mit Epilepsie höher als bei Kontrollen und ähnlich wie bei Menschen mit einer Depression [47].…”

“…Anders als bei einer Depression sind bei Epilepsien die täglichen Schwankungen jedoch oft nicht vorhanden [47]. Faktoren, die die Aktivität der HPA-Achse erhöhen, stören sowohl die reproduktive endokrine Sekretion als auch die reproduktive Funktion [6,[46][47][48][49][50] und können zu einer Anfallsexazerbation beitragen [6].…”

“…Beide hemmen die Gonadotropinsekretion und die reproduktive Funktion [46][47][48][49][50]. ACTH erhöht die Kortisolsekretion; Endorphine erhöhen die Dehydroepiandrosteron (DHEA)-Produktion.…”

Changes of serum adrenocorticotropic hormone and cortisol levels during sleep seizures

“…The control group was composed of patients with confirmed PNES, the onset of which were not accompanied by changes in ACTH levels [5] . Seizures during sleep most likely occur between 2-3 o'clock in the morning or about 30 min after falling asleep or 30 min before waking up.…”