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Gender-specific aspects in pediatric epileptology

Geschlechtsspezifische Unterschiede in der pädiatrischen Epileptologie

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Abstract

Background

Epilepsy is one of the most prevalent neurological disorders in children. Epilepsy, and the use of antiseizure medications (ASM), can influence the metabolic and endocrine systems. Particularly during puberty, it is crucial to consider gender-specific aspects in the treatment and management of epilepsy.

Objective

This narrative review outlines gender-specific factors in children with epilepsy regarding hormones, metabolism, and the effect of ASM.

Material and methods

Through a MEDLINE search with the keywords “epilepsy,” “children,” “gender,” and “hormone” or “metabolic,” relevant articles were selected and summarized. We tried to categorize the results into endocrinological and metabolic aspects that apply not only to both genders but also specifically to female and male patients with epilepsy.

Results

Children with epilepsy are at a greater risk of experiencing alterations in sexual and thyroid hormones as well as in bone markers depending on the ASM treatment. Female patients with epilepsy are at increased risk for obesity, amenorrhea, oligomenorrhea, anovulation, polycystic ovary syndrome, hyperandrogenism, and dyslipidemia. Male patients with epilepsy have a high likelihood of experiencing sexual dysfunction.

Conclusion

Metabolic and hormonal alterations are common in children with epilepsy. Gender-specific differences become more pronounced during puberty and are often correlated with ASM treatment.

Zusammenfassung

Hintergrund

Epilepsie zählt zu den häufigsten neurologischen Erkrankungen im Kindes- und Jugendalter. Dabei kann Epilepsie und die Behandlung mit antikonvulsiver Medikation Auswirkungen auf das metabolische und endokrinologische System haben. Vor allem in der Pubertät gilt es, geschlechtsspezifische Aspekte im Zusammenhang mit Epilepsie und deren Therapie zu beachten.

Ziel der Arbeit

Dieser narrative Review gibt einen Überblick über geschlechtsspezifische Unterschiede von Kindern und Jugendlichen mit Epilepsie im Hinblick auf Hormone und Stoffwechsel sowie den Einfluss von antikonvulsiver Medikation.

Material und Methoden

Dazu wurden relevante Artikel durch eine MEDLINE-Recherche mit den Schlüsselwörtern „epilepsy“, „children“, „gender“, und „hormone“ oder „metabolic“ ausgewählt und zusammengefasst. Zunächst werden allgemeine endokrinologische und metabolische Auffälligkeiten und anschließend geschlechtsspezifische Aspekte für weibliche und männliche Patienten dargestellt.

Ergebnisse

Kinder und Jugendliche mit Epilepsie sind einem höheren Risiko sowohl für hormonelle Veränderungen als auch für Veränderungen in der Knochendichte ausgesetzt, welches durch die antikonvulsive Medikation beeinflusst werden kann. Bei Mädchen besteht ein erhöhtes Risiko für Übergewicht, Amenorrhö, Oligomenorrhö, Anovulation, Syndrom der polyzystischen Ovarien, Hyperandrogenämie und Dyslipidämie. Ein hoher Anteil männlicher Patienten mit Epilepsie leidet an sexueller Dysfunktion.

Schlussfolgerung

Epilepsie wirkt sich auf Stoffwechsel und Hormone bei Mädchen und Jungen unterschiedlich aus. Geschlechtsspezifische Unterschiede sind v. a. in der Pubertät festzustellen und stehen häufig im Zusammenhang mit antikonvulsiver Medikation.

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Acknowledgements

We thank Alyssa Ho for support in checking the English.

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Authors and Affiliations

  1. Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, Montreal, Canada

    Katharina Schiller

  2. Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria

    Katharina Schiller &  Markus Rauchenzauner

  3. Department of Pediatrics, Hospital Group Kaufbeuren-Ostallgäu, Kaufbeuren, Germany

    Katharina Schiller & Veronika Schiller

  4. Specialist Center for Paediatric Neurology, Neurorehabilitation and Epileptology, Schön Klinik Vogtareuth, Krankenhausstraße 20, 83569, Vogtareuth, Germany

    Markus Rauchenzauner

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  1. Katharina Schiller
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  2. Veronika Schiller
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Correspondence to Markus Rauchenzauner.

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Conflict of interest

K. Schiller, V. Schiller and M. Rauchenzauner declare that they have no competing interests.

The authors conducted no research in humans for this manuscript. For the cited articles the ethical guidelines apply which are listed accordingly.

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The authors K. Schiller and V. Schiller contributed equally to this paper.

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We do not analyze or generate any datasets, because our work proceeds within a theoretical approach.

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Schiller, K., Schiller, V. & Rauchenzauner, M. Gender-specific aspects in pediatric epileptology. Clin Epileptol 36, 212–216 (2023). https://doi.org/10.1007/s10309-023-00606-z

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