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Neuroendocrine aspects of catamenial epilepsy.
- Source :
-
Hormones and behavior [Horm Behav] 2013 Feb; Vol. 63 (2), pp. 254-66. Date of Electronic Publication: 2012 May 02. - Publication Year :
- 2013
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Abstract
- This review describes the neuroendocrinological aspects of catamenial epilepsy, a menstrual cycle-related seizure disorder in women with epilepsy. Catamenial epilepsy is a multifaceted neuroendocrine condition in which seizures are clustered around specific points in the menstrual cycle, most often around perimenstrual or periovulatory period. Three types of catamenial seizures (perimenstrual, periovulatory and inadequate luteal) have been identified. The molecular pathophysiology of catamenial epilepsy remains unclear. Cyclical changes in the circulating levels of estrogens and progesterone (P) play a central role in the development of catamenial epilepsy. Endogenous neurosteroids such as allopregnanolone (AP) and allotetrahydrodeoxycorticosterone (THDOC) that modulate seizure susceptibility could play a critical role in catamenial epilepsy. In addition, plasticity in GABA-A receptor subunits could play a role in the enhanced seizure susceptibility in catamenial epilepsy. P-derived neurosteroids such as AP and THDOC potentiate synaptic GABA-A receptor function and also activate extrasynaptic GABA-A receptors in the hippocampus and thus may represent endogenous regulators of catamenial seizure susceptibility. Experimental studies have shown that neurosteroids confer greater seizure protection in animal models of catamenial epilepsy, especially without evident tolerance to their actions during chronic therapy. In the recently completed NIH-sponsored, placebo controlled phase 3 clinical trial, P therapy proved to be beneficial only in women with perimenstrual catamenial epilepsy but not in non-catamenial subjects. Neurosteroid analogs with favorable profile may be useful in the treatment of catamenial epilepsy.<br /> (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Subjects :
- Animals
Epilepsy etiology
Epilepsy therapy
Female
Hormone Replacement Therapy methods
Hormones blood
Hormones physiology
Humans
Menstrual Cycle blood
Menstrual Cycle physiology
Menstruation Disturbances blood
Menstruation Disturbances complications
Menstruation Disturbances physiopathology
Menstruation Disturbances therapy
Neurosecretory Systems physiology
Neurotransmitter Agents blood
Neurotransmitter Agents physiology
Neurotransmitter Agents therapeutic use
Epilepsy physiopathology
Neurosecretory Systems physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6867
- Volume :
- 63
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Hormones and behavior
- Publication Type :
- Academic Journal
- Accession number :
- 22579656
- Full Text :
- https://doi.org/10.1016/j.yhbeh.2012.04.016