Division of Epilepsy and Electroencephalography, Hofstra North Shore-LIJ School of Medicine at Hofstra University, Hempstead, NY, USA.
Lancet Neurol. 2013 Jan;12(1):72-83. doi: 10.1016/S1474-4422(12)70239-9.
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.
激素、癫痫发作以及用于控制这些疾病的药物之间复杂的、多向的相互作用，给治疗癫痫患者的临床医生带来了挑战。许多激素作为神经甾体，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不仅可以直接影响癫痫发作的发生，还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。癫痫的潜在结构和生理脑异常以及抗癫痫药物的代谢活性可能会对下丘脑和性腺功能产生不利影响。对这些复杂相互作用的认识不断增加，现在可以纳入针对癫痫患者的有意义的治疗方法中。
