Abnormal pulsatile secretion of luteinizing hormone in men with epilepsy: relationship to laterality and nature of paroxysmal discharges

Men with epilepsy can develop reproductive and sexual dysfunctions that may result from alterations in the hormonal output of the pituitary gland (the 'master' endocrine gland). Since the pituitary is under the control of the hypothalamus (a region in the brain), which sends releasing and inhibiting hormones to the pituitary, it is possible that seizures affect this delicate relationship. Gonadotropins (which stimulate the testes in the male and the ovary in the female) are one class of hormones secreted by the pituitary; this group includes luteinizing hormone (LH). To determine whether epilepsy is associated with abnormalities of LH secretion, 13 men with seizures in the temporal lobes of the brain and eight age-matched, non-epileptic control subjects were studied. Both groups were monitored for eight hours with EEG telemetry (constant measurement of the brain's electrical activity), and blood was drawn every 15 minutes for measurement of LH levels. Results showed no differences between patients and controls for the average baseline level and total level of LH secretion; in addition, the LH pulse amplitude (amount of a rapid increase) and frequency of pulses were the same. The epileptic patients, however, had more variability in their average baseline secretion and their pulse frequency, and nine patients had baseline LH levels that were either higher or lower than the normal range. Other LH pulse abnormalities were noted that correlated with the localization of the epileptiform (epileptic) electrical discharge pattern. It is possible that anticonvulsant medication led to the changes noted; however, no pattern was observed that seemed to correlate with the medication types or schedules. A hypothesis is presented regarding the ways that epilepsy and sexual and reproductive dysfunction could be related. The results support the possibility that epileptic activity affects the relationship between the pituitary and hypothalamus. (Consumer Summary produced by Reliance Medical Information, Inc.)