Document Detail


Endocrine effects of valproate in adolescent girls with epilepsy.
MedLine Citation:
PMID:  17326798     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate the effect of epilepsy and/or valproate (VPA) monotherapy on physical growth, weight gain, pubertal development, and hormonal status in adolescent girls with epilepsy. METHODS: The study group included 88 consecutive female patients with epilepsy aged 6-20 years (28 premenarche, 60 postmenarche) attending an endocrinology institute of a major tertiary center. Forty-five patients were under treatment with VPA, and 43 were before treatment initiation. The groups were compared for the relevant biochemical, anthropometric, ultrasonographic, and endocrine parameters. RESULTS: No statistically significant differences were found in any of the parameters studied between the groups, as a whole or by menarche status. The treated postmenarcheal subgroup had a higher mean testosterone level than the untreated postmenarcheal controls (1.83 +/- 0.65 vs. 0.88 +/- 0.24, p=0.006). Body mass index--standard deviation score (BMI-SDS) was 0.75 in the treated group and 0.63 in the untreated group; rates of obesity were 16.3% and 15.5%, respectively. No between-group differences were found in menses irregularities, hirsutism, or acne. No correlation was found between duration or dosage of treatment and BMI-SDS, height-SDS, or androgen level. The treated group had higher levels of thyroid-stimulating hormone and lower levels of free thyroxine than did the untreated group, although still within normal range. CONCLUSIONS: Long-term treatment with VPA in girls with epilepsy is associated with increased testosterone levels after menarche, without clinical hyperandrogenism, polycystic ovary syndrome, or an increase in BMI-SDS. VPA is a good treatment option in this age group but should be accompanied by careful endocrine observation.
Authors:
Liat de Vries; Anna Karasik; Zohar Landau; Moshe Phillip; Sara Kiviti; Hadassa Goldberg-Stern
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-02-22
Journal Detail:
Title:  Epilepsia     Volume:  48     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-05-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  470-7     Citation Subset:  IM    
Affiliation:
Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Petah Tiqwa, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticonvulsants / pharmacology*,  therapeutic use*
Body Height / drug effects
Body Mass Index
Child
Comorbidity
Epilepsy / blood*,  drug therapy*
Female
Humans
Menarche / drug effects
Obesity / diagnosis,  epidemiology
Polycystic Ovary Syndrome / diagnosis,  epidemiology
Testosterone / blood*
Thyrotropin / blood*
Thyroxine / blood*
Valproic Acid / pharmacology*,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anticonvulsants; 58-22-0/Testosterone; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin; 99-66-1/Valproic Acid

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