Neuroendocrine considerations in the treatment of men and women with epilepsy.
Neuroendocrine considerations in the treatment of men and women with epilepsy.
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DOI：
10.1016/s1474-4422(12)70239-9
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发表时间：
2013-01
期刊：
影响因子：
--
通讯作者：
Pennell PB
中科院分区：
文献类型：
--
作者：
Harden CL;Pennell PB
激素，癫痫发作和用于控制它们的药物之间复杂，多方向的相互作用可能对治疗癫痫患者的临床医生提出挑战。许多激素作为神经类固醇，通过直接结合位点调节大脑兴奋性。因此，内源性或外源性激素水平的变化可以直接影响癫痫发作的发生，也可以通过改变抗癫痫药物浓度的药代动力学效应间接影响癫痫发作的发生。癫痫的潜在脑结构和生理异常以及抗癫痫药物的代谢活性可对下丘脑和性腺功能产生不利影响。这些复杂的相互作用的知识已经增加，现在可以纳入有意义的治疗方法，男性和女性癫痫。
Complex, multidirectional interactions between hormones, seizures, and the medications used to control them can present a challenge for clinicians treating patients with epilepsy. Many hormones act as neurosteroids, modulating brain excitability via direct binding sites. Thus, changes in endogenous or exogenous hormone levels can affect the occurrence of seizures directly as well as indirectly through pharmacokinetic effects that alter the concentrations of antiepileptic drugs. The underlying structural and physiological brain abnormalities of epilepsy and the metabolic activity of antiepileptic drugs can adversely affect hypothalamic and gonadal functioning. Knowledge of these complex interactions has increased and can now be incorporated in meaningful treatment approaches for men and women with epilepsy.