Zusammenfassung
Fokale Epilepsien nehmen Einfluss auf die hypothalamisch-hypophysäre Funktionsachse. Anfälle induzieren einen heftigen, kurzzeitigen Anstieg hypophysärer Hormone. Interiktale epileptische Aktivität hingegen beeinflusst die Hormonachse nachhaltiger. Insbesondere Epilepsien temporalen Ursprungs (TLE) mindern die Serumkonzentration des freien Testosteron und des Quotienten aus Testosteron und luteotropem Hormon, woraus ein testikulärer Einfluss der Erkrankung abzulesen ist. Erst die erfolgreiche Supprimierung interiktaler epileptischer Aktivität durch eine epilepsiechirurgische Behandlung von TLE führt innerhalb des ersten postoperativen Jahres zu einem signifikanten Anstieg der präoperativ verminderten Serumkonzentration von Androgenen. Der Einfluss fokaler Epilepsien auf endokrine Funktionen unterstreicht, dass Epilepsien Erkrankungen sind, die nicht nur mit der Manifestation epileptischer Anfälle einhergehen.
Abstract
Focal epilepsies have impact on the hypothalamic-pituitary axis. Seizures cause a short-lasting increase in serum levels of pituitary hormones. However, the impact of interictal focal epileptic activity is long-lasting. Especially in men with temporal lobe epilepsy (TLE) serum levels of free testosterone and the testosterone/luteotrophic hormone ratio is decreased, indicating a testicular malfunction. Following a successful epilepsy surgery in men with TLE a significant increase in serum androgen levels is observed within a 12 month follow-up. The endocrine effects of focal epilepsies are an example to underline that the symptomatology of epilepsy is not limited to the manifestation of seizures.
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Prof. Dr. Jürgen Bauer
Universitätsklinikum Bonn · Klinik für Epileptologie
Sigmund-Freud-Straße 25
53105 Bonn
Email: juergen.bauer@ukb.uni-bonn.de
