Seizures and reproductive ills linked

Women with epilepsy are more likely to have reproductive disorders than are other women. Two new studies shed light on the biology behind this link.

The temporal lobes–the parts of the brain just behind the temples–communicate with other areas of the brain that regulate sex hormones. So, Andrew H. Herzog of the Beth Israel Deaconess Medical Center in Boston recruited 36 women whose seizures were triggered by abnormal bursts of activity in their temporal lobes. He and his colleagues monitored the electrical signals in the women’s brains for 8 straight hours and took blood samples every 10 minutes.

During the study, none of the women had a clinically detectable seizure, but most had brief, abnormal discharges of electrical activity in their brain, Herzog reported in October at a meeting of the Epilepsy Foundation in Las Vegas. After such a burst, the blood concentration of the reproductive hormone prolactin spiked threefold within 10 minutes and then dropped below its starting point. The electrical bursts also disrupted the brain’s cyclic release of luteinizing hormone, or LH, which stimulates the ovaries to make estrogen and progesterone.

In another study reported at the meeting, researchers linked abnormal pulses of LH with an increased risk of polycystic ovary syndrome, a disease characterized by abnormal ovulation, the presence of multiple unreleased eggs in ovaries, and infertility.

Martha J. Morrell of Columbia University followed 100 women–75 with epilepsy and 25 without–by measuring LH in their blood and urine samples for three consecutive menstrual cycles. During one of each woman’s menstrual cycles, physicians took blood samples every 10 minutes for 8 hours.

Women with epilepsy were more likely to have abnormal patterns of LH release, Morrell found. Among women with normal patterns of LH release, about 27 percent showed ultrasound evidence of multiple unreleased eggs. In contrast, 57 percent of women with abnormal LH pulses showed this sign of polycystic ovary syndrome.

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