Seizure Frequency and Cortisol and Dehydroepiandrosterone Sulfate (DHEAS) Levels in Women with Epilepsy Receiving Antiepileptic Drug Treatment

• Published in: Epilepsia (Copenhagen) Vol. 46; no. 4; pp. 517 - 523
• Main Authors: Andrea Galimberti, Carlo, Magri, Flavia, Copello, Francesco, Arbasino, Carla, Cravello, Luca, Casu, Massimo, Patrone, Vittoriana, Murialdo, Giovanni
• Format: Journal Article
• Language: English
• Published: 350 Main Street , Malden , MA 02148 , USA and 9600 Garsington Road , Oxford , OX4 2XG , England Blackwell Science Inc 01-04-2005; Blackwell
• Subjects: Adolescent; Adult; Age Factors; Anticonvulsants - blood; Anticonvulsants - therapeutic use; Anticonvulsants. Antiepileptics. Antiparkinson agents; Antiepileptic drugs; Biological and medical sciences; Body Mass Index; Circadian Rhythm; Cortisol; Cross-Sectional Studies; Dehydroepiandrosterone sulfate; Dehydroepiandrosterone Sulfate - blood; Drug Therapy, Combination; Drug toxicity and drugs side effects treatment; Enzyme Induction - physiology; Epilepsy; Epilepsy - blood; Epilepsy - drug therapy; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Hydrocortisone - blood; Medical sciences; Middle Aged; Miscellaneous (drug allergy, mutagens, teratogens...); Nervous system (semeiology, syndromes); Neurology; Neuropharmacology; Pharmacology. Drug treatments; Severity of Illness Index; Sex Factors; Human; Corticosteroid; Nervous system diseases; Epilepsy-Antiepileptic drugs- Cortisol-Dehydroepiandrosterone sulfate; Steroid hormone; Epilepsy; Antiinflammatory agent; Anticonvulsant; Hydrocortisone; Sulfates; Glucocorticoid; Cerebral disorder; Treatment; Adrenal hormone; Central nervous system disease
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.0013-9580.2005.59704.x

Purpose: Hormonal changes occur in epilepsy because of seizures themselves and of antiepileptic drug (AED) effects on steroid production, binding, and metabolism. Conversely, steroids may influence neuron activity and excitability by acting as neuroactive steroids. This cross‐sectional observational study aimed to evaluating cortisol and dehydroepiandrosterone sulfate (DHEAS) levels in female epilepsy patients with different disease severity, as assessed by a seizure frequency score (SFS).
Methods: Morning serum levels of cortisol and DHEAS were assayed in 113 consecutive women, aged 16 to 47 years, with varied epilepsy syndromes, receiving mono‐ or polytherapy with enzyme‐inducing and/or noninducing antiepileptic drugs (AEDs). Hormonal data were correlated with clinical parameters (age, body mass index, epilepsy syndrome, disease onset and duration, SFS, AED therapy, and AED serum levels) and compared with those of 30 age‐matched healthy women.
Results: In epilepsy patients, cortisol levels and cortisol‐to‐DHEAS ratios (C/Dr) were significantly higher, whereas DHEAS levels were significantly lower than those in controls. Patients with more frequent seizures showed higher cortisol and C/Dr values and lower DHEAS levels than did those with rarer or absent seizures during the previous 6 months. SFS mainly explained the increase of cortisol levels and C/Dr in patients with more active disease. Changes in DHEAS levels correlated with SFS and epilepsy syndrome, as well as with AED treatments and ages.
Conclusions: Women with more frequent seizures had alterations of their adrenal steroids characterized by an increase of cortisol and a decrease of DHEAS levels. Such hormonal changes might be relevant in seizure control and in patient health.