Seizure Control With Clomiphene Therapy

Herzog, Andrew G.

doi:10.1001/archneur.1988.00520260097027

Cited by 13 publications

(6 citation statements)

References 13 publications

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“…It exerts a dose-dependent antiepileptic effect in rats (7). Remarkable reductions in seizure frequency have been reported with clomiphene in a number of isolated cases in both men and women (79,80). In one series of 12 women who had complex partial seizures and menstrual disorders (polycystic ovarian syndrome or inadequate luteal phase cycles) and who were given clomiphene, 10 improved, many dramatically, with an 87% average decline in seizure frequency (81).…”

Section: Clomiphenementioning

confidence: 97%

Hormonal Effects on Epilepsy in Women

Klein

Herzog

1998

Epilepsia

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This review focuses on basic scientific and clinical data concerning the effects of female gonadal and adrenal steroid hormones, as well as their related neuropeptides, on neuronal excitability and seizures, and on hormonal and hormonally derived treatments for epilepsy. HORMONAL EFFECTS ON NEURONAL EXCITABILITY AND SEIZURES: ANIMAL DATAGonadal and adrenal steroids act in the brain by longlatency receptor-mediated genomic and post-transcriptional mechanisms and by short-latency direct membrane-mediated actions (1,2). These steroids have wideranging influences on neuronal excitability and seizures in animal models (3). EstrogensPhysiologic and pharmacologic doses of estrogens lower seizure thresholds in most adult animal seizure models (4-8). However, ovariectomy in adult rats does not alter seizure threshold (5). Therefore, whereas estro-

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Section: Clomiphenementioning

confidence: 97%

Hormonal Effects on Epilepsy in Women

Klein

Herzog

1998

Epilepsia

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“…Seizures were eliminated during clomiphene use in another case with epilepsy and oligospermia (Check et al, 1982). It offered no benefit, however, for a man who had complex partial seizures and hypergonadotropic hypogonadism, i.e., gonadal failure (Herzog, 1988). Total and free AED levels were not affected.…”

Section: Clomiphene Therapymentioning

confidence: 96%

Reproductive Endocrine Considerations and Hormonal Therapy for Men with Epilepsy

Herzog

1991

Epilepsia

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Androgen deficiency is unusually common among men with epilepsy. It may contribute to reproductive and sexual dysfunction and possibly exacerbate seizure frequency. The most important androgen is testosterone. it exists in the serum in a free form or bound to albumin or sex hormone-binding globulin (SHBG). Free testosterone levels have correlated significantly with measures of potency and sexual interest. The possibility that measures of non-SHBG-bound testosterone may provide a more sensitive assessment of biologically and perhaps clinically significant androgen levels is raised for consideration. Androgen deficiency may result from increased catabolism and binding induced by antiepileptic drugs (AEDs). It is a feature of the reproductive endocrine disorders that are often associated with epilepsy: hypogonadotropic hypogonadism, hypergonadotropic hypogonadism, and functional hyperprolactinemia. It may be a consequence of medication-induced elevations in serum estradiol. Estradiol exerts a potent inhibitory influence on luteinizing hormone secretion and may contribute to premature aging of the reproductive system, both at the level of the testes and the hypothalamus. Testosterone therapy may moderately benefit reproductive and sexual function. Despite its antiseizure effects in animal experiments, however, it has not been reported to improve seizures clinically. One possible explanation is that AEDs that induce enzyme synthesis may enhance the conversion of testosterone to estradiol by aromatase. This possibility is supported by the improved seizure control achieved with the adjunctive use of the aromatase inhibitor testolactone or the antiestrogen clomiphene.

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“…The association of temporal lobe lesions and epileptic seizures with ED has been reported [26][27][28]. Herzog et al…”

Section: Epilepsymentioning

confidence: 97%

“…have suggested that epileptic discharges in the medial temporal lobe may disrupt hypothalamic regulation of pituitary secretion and result in increased prolactin and decreased testosterone levels [27]. Epilepsy, while neurogenic in origin, can therefore result in endocrinologic ED.…”

Section: Epilepsymentioning

confidence: 99%

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Neurogenic erectile dysfunction

Lue

2001

Clinical Autonomic Research

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Penile erection is a neurovascular event modulated by psyche and hormones. Erectile dysfunction (ED) has been classified as psychogenic, arteriogenic, neurogenic, endocrinologic, and cavernosal, based on the organs that are involved in penile erection. Among these types, neurogenic ED may be the most common, probably because a deficiency of neurotransmitters is the final common pathway in many diseases and conditions. This review discusses the physiology, pathophysiology, diagnosis, and treatment of erectile function and dysfunction, as well as strategies for future research.

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Seizure Control With Clomiphene Therapy

Cited by 13 publications

References 13 publications

Hormonal Effects on Epilepsy in Women

Hormonal Effects on Epilepsy in Women

Reproductive Endocrine Considerations and Hormonal Therapy for Men with Epilepsy

Neurogenic erectile dysfunction

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