Reproductive Endocrine Disorders in Women With Partial Seizures of Temporal Lobe Origin

Herzog, Andrew G.; Seibel, M. M.; Schomer, Donald L.; Vaitukaitis, Judith L.; Geschwind, N.

doi:10.1001/archneur.1986.00520040029014

Cited by 355 publications

(254 citation statements)

References 3 publications

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“…In addition, the locus of pathology on the long axis is associated with specific cognitive impairments (for example, schizophrenia is associated with anterior hippocampal pathology and with impaired transitive inference [159][160] ) as well as with clinical manifestations of particular diseases. For example, in view of the greater connectivity between ventral (anterior) hippocampus and endocrine hypothalamic nuclei 26 , impaired hormonal regulation by the hypothalamus (such as hyponataraemic polydypsia reported in schizophrenia patients with decreased AH volume [161][162][163] ) may be a common finding in patients with AH damage -this is something that has been relatively under-investigated in medial temporal lobe epilepsy [164][165][166] . Furthermore, given the role of VH 111 -and ventral DG in particular 167 -in models of innate anxiety, this region could prove an important future target for a range of neurotic disorders.…”

Section: Discussionmentioning

confidence: 99%

Functional organization of the hippocampal longitudinal axis

Witter²,

et al. 2014

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The precise functional role of the hippocampus remains a topic of much debate. According to a dominant view, the dorsal/posterior hippocampus is implicated in memory and spatial navigation and the ventral/anterior hippocampus mediates anxietyrelated behaviours. However, this 'dichotomy view' may need revision. Gene expression studies demonstrate multiple functional domains along the hippocampal long axis, which often exhibit sharply demarcated borders. By contrast, anatomical studies and electrophysiological recordings in rodents suggest that the long-axis is organized along a gradient. Together, these observations suggest a model in which functional long-axis gradients are superimposed on discrete functional domains. This model provides a potential framework to explain and test the multiple functions ascribed to the hippocampus.The hippocampus is a medial temporal lobe structure critically involved in episodic memory and spatial navigation [1][2][3][4][5][6][7] . Its long, curved form is present across all mammalian orders and runs along a dorsal (septal) to ventral (temporal) axis in rodents, corresponding to a posteriorto-anterior axis in humans (FIG. 1a-b). The same basic intrinsic circuitry is maintained throughout the long axis and across species (FIG. 1c). Despite this conserved intrinsic circuitry, the dorsal and ventral portions have different connectivities with cortical and subcortical areas, and this has long posed a question as to whether the hippocampus is functionally uniform along this axis. Here we review cross-species data that show how the seemingly disparate functions ascribed to the hippocampus can be accommodated by a model in which different functional properties exist along the longitudinal axis.The severe memory impairment suffered by patient H.M. following bilateral hippocampal resection 1 led to intensive study 8 of patients and animal models with hippocampal damage, with an ensuing characterisation of hippocampal function in terms of declarative memory 2 , encompassing both episodic and semantic memory. At the same time, however, evidence emerged for a hippocampal role in spatial memory, based on the discovery of hippocampal 'place cells' 9,10 and the demonstration that hippocampal lesions impair spatial memory 4 . Both the declarative memory hypothesis 11 and the spatial mapping hypothesis 12 of hippocampal function proposed a unitary model in which the entire hippocampus is dedicated

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Section: Discussionmentioning

confidence: 99%

Functional organization of the hippocampal longitudinal axis

Witter²,

et al. 2014

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“…Increased rates of reproductive and endocrine disorders have been documented in women with epilepsy for both primarily generalized (2), and partial epilepsies (3). Valproate (VPA) has been implicated in the development of polycystic ovarian disease and hyperandrogenism in women with epilepsy (4).…”

Section: Discussionmentioning

confidence: 99%

Male Infertility: Possible Association with Valproate Exposure

Yerby

McCoy

1999

Epilepsia

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Summary: Purpose: To describe a potential association between male infertility and valproate (VPA) exposure. VPA has been implicated in the development of polycystic ovarian disease and subsequent menstrual and infertility problems in women with epilepsy. Infertility has been well described in population-based studies of persons with epilepsy. The low marital rates for men with epilepsy have previously been thought to play a major contributing role.Methods: We report a case of a 32-year-old man whose wife and he were able to bear a child before the development of his epilepsy. With VPA monotherapy, the family were unable to conceive despite 4 years of unprotected intercourse. An infertility evaluation of the man revealed a very low sperm count of <50,00O/ml, no motile sperm, I6 million, 50% motility, 78% viability, and 72% with abnormal structure.Conclusions: One must be cautious in extrapolating from a case report, but these findings strongly suggest a direct effect of VPA on spermatic structure and function. Key Words: Valproate-Infertility-Epilepsy .It has been established that people with epilepsy, particularly women, have significantly lower fertility rates than persons without this disorder (1). Increased rates of reproductive and endocrine disorders have been documented in women with epilepsy for both primarily generalized (2), and partial epilepsies (3). Valproate (VPA) has been implicated in the development of polycystic ovarian disease and hyperandrogenism in women with epilepsy (4). Social and biologic influences affecting fertility in both men and women with epilepsy were studied by Schupf and Ottman (3, but relatively little attention has been paid to the issues of infertility in men with epilepsy. Chen et al. (6) studied the in vitro effect of antiepileptic drugs (AEDs) on human spermatic motility. They demonstrated marked inhibition of motility with exposure to phenytoin (PHT), carbamazepine (CBZ), and VPA. We report a case of a man with partial epilepsy whose infertility appeared to be associated with VPA exposure.

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“…Hormonstörungen sind relativ häufig bei Frauen und Männern mit Epilepsie [1][2][3]. Diese manifestieren sich bei Frauen als Zyklusstörungen, Hirsutismus und Infertilität [2] und als Libidoverlust, Impotenz und Infertilität bei Männern [3].…”

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“…Diese manifestieren sich bei Frauen als Zyklusstörungen, Hirsutismus und Infertilität [2] und als Libidoverlust, Impotenz und Infertilität bei Männern [3]. Genaue Pathomechanismen von Sexualhormonstörungen sind nur unvollständig geklärt.…”

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“…Genaue Pathomechanismen von Sexualhormonstörungen sind nur unvollständig geklärt. Infrage kommen sowohl Störungen der HypothalamusHypophysen-Achse (HPA) durch epileptische Anfälle oder temporolimbische Entladungen, als auch Einflüsse der Antiepileptika auf den Steroidhormonstoffwechsel [1][2][3][4][5]. Epilepsien und AEDs können, um die Hormonspiegel zu beeinflussen, eine Vielzahl von Substraten anpeilen.…”

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Hormon- und Sexualstörungen bei Epilepsie

Luef

2018

Z. Epileptol.

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Reproductive Endocrine Disorders in Women With Partial Seizures of Temporal Lobe Origin

Cited by 355 publications

References 3 publications

Functional organization of the hippocampal longitudinal axis

Functional organization of the hippocampal longitudinal axis

Male Infertility: Possible Association with Valproate Exposure

Hormon- und Sexualstörungen bei Epilepsie

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