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Neurogonadale Interaktionen bei Frauen mit Epilepsie

Neurogonadal interactions in women with epilepsy

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Zusammenfassung

Die Behandlung von Frauen mit Epilepsie (WWE) stellt auch den Gynäkologen vor komplexe Anforderungen. Einerseits können die hormonellen Veränderungen während des menstruellen Zyklus das Auftreten von epileptischen Anfällen begünstigen, andererseits können epileptische Anfälle zu Veränderungen der zirkulierenden Hormone (Gonadotropine, Prolaktin, Sexualsteroide) führen. Es bestehen multidirektionale neurogonadale Interaktionen zwischen den Impulsen der zentralnervösen Erregungsstörung im Anfallsgeschehen sowie interiktal mit resultierender Dysbalance der hypothalamisch-hypophysären Funktion, dem neuroaktiven Potenzial der gonadalen Steroide und der endokrinen Modulation durch die antiepileptische Medikation (AED). Auf der Basis der hierzu bekannten pathophysiologischen Fakten und klinischen Beobachtungen werden klinische Szenarien und mögliche Therapieoptionen besprochen.

Abstract

Clinical management for women with epilepsy (WWE) is a complex problem for gynecologists. On the one hand, the hormonal changes during the menstrual cycle can bring on epileptic fits; on the other hand, epileptic fits can lead to changes in the circulating hormones (gonadotropins, prolactin, sex steroids). Reproductive endocrine function is affected by multidirectional neurogonadal interactions between epileptic and interictal discharges of the central nervous system, resulting in an unbalanced hypothalamic–pituitary function, the neuroactive potential of gonadal steroids and the endocrine modulation of antiepileptic drugs (AED). Based on known pathophysiological facts and clinical observations relevant clinical scenarios and therapeutic options are discussed in this article.

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Authors and Affiliations

  1. Medizinische Fakultät der RWTH Aachen, Universitäts-Frauenklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Pauwelsstraße 30, 52074, Aachen, Deutschland

    Benjamin Rösing

  2. Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Department Frauenheilkunde Medizinische Universität Innsbruck, Innsbruck, Österreich

    Ludwig Wildt

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  1. Benjamin Rösing
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Correspondence to Benjamin Rösing.

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Rösing, B., Wildt, L. Neurogonadale Interaktionen bei Frauen mit Epilepsie. Z. Epileptol. 28, 271–278 (2015). https://doi.org/10.1007/s10309-015-0018-1

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