Trastornos Neurológicos Asociados a Terapéutica Hormonal.
Palabras clave:
trastornos neurológicos, terapéutica hormonal, neurología, endocrinologíaResumen
ResumenAunque la terapia de reemplazo hormonal (TRH) y los anticonceptivos orales estadísticamente aumentan las posibilidades de accidentes cerebrovasculares (ACV) en las mujeres, el riesgo absoluto es muy bajo en ausencia de factores de riesgo. Los anticonceptivos orales (AO) pueden agravar o provocar migraña en mujeres susceptibles. El tamoxifeno aumenta el riesgo de enfermedades tromboembólicas. En mujeres que sufren un derrame cerebral mientras toman tamoxifeno, se debe descartar la presencia de una trombosis venosa profunda en presencia de un foramen ovale patente.
Los pacientes con epilepsia pueden recibir TRH, AO y andrógenos, pero se necesita el monitoreo de niveles sanguíneos de las drogas antiepilépticas. Las mujeres requerirán asesoramiento en cuanto a embarazos no deseados y a la teratogenicidad de los antiepilépticos. Las drogas dopaminérgicas utilizadas en el manejo de los prolactinomas pueden causar rinorrea proveniente del líquido céfalo-raquídeo y las pruebas dinámicas con hormonas liberadoras pueden causar una apoplejía hipofisiaria en pacientes que tienen macroadenomas.
SummaryAlthough hormonal replacement therapy and oral contraceptives statistically increase the chances of stroke in women, the absolute risk of stroke is very low in the absence of risk factors. Oral contraceptives may aggravate or cause migraine in susceptible women. Tamoxifen increases the risk of thrombo-embolic disease. Deep venous thrombosis and patent foramen ovale must be rule out in women suffering a stroke while on tamoxifen. Patients with epilepsy can be safely prescribed hormonal replacement therapy, oral contraceptives and androgens, but antiepileptic drug blood levels need monitoring. Women will require counseling in regards to unwanted pregnancies and the teratogenic properties of antiepileptics. Dopamine agonist drugs may induce cerebrospinal fluid rhinorrhea, and endocrine testing with releasing hormones may cause pituitary apoplexy in patients with macroadenomas.
Biografía del autor/a
Alfredo Jácome-Roca, Academia Nacional de Medicina
Daniel Jácome-Roca, Darmouth Medical College
Referencias bibliográficas
Bushnell CD. Estrogen and stroke in women: assessment of risk. Lancet Neurol 2005; 4: 743-751.
Writing group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy post-menopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002; 288: 321- 333.
The Women’s Health Initiative Steering Committee. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy. JAMA 2004; 291: 1701-1712.
Viscoli CM, Brass LM, Kernan WN, Sarrel PM, Suissa S, Horwitz RI. A clinical trial of estrogen-replacement therapy after ischemic stroke. N Engl J Med 2001; 345: 1243-1249.
Bushnell CD. Hormone replacement therapy and stroke: the current state of knowledge and directions for future research. Semin Neurol 2006; 26: 123- 130.
Sherman AM, Cooper JA, Kotwinski PJ, Humphries SE, Mendelsohn ME, Housman DE, et al. Estrogen receptor alpha gene variation and the risk of stroke. Stroke 2005; 36:2281-2282.
Geiger AM, Fishberg GM, Chen W, Bernstein L. Stroke risk and tamoxifen therapy for breast cancer. J Natl Cancer Inst 2004; 96: 1528-1536.
Bushnell CD, Goldstein LB. Risk of ischemic stroke with tamoxifen treatment for breast cancer. A metaanalysis. Neurology 20004; 63: 1230-1233.
Barrett-Connor E, Grady D, Sashegyi A, Anderson PW, Cox DA, Hoszowski K, et al. Raloxifene and cardiovascular events in osteoporotic postmenopausal women. Four-year results from the MORE (Multiple Outcomes of Raloxifene Evaluation) randomized trial. JAMA 2002; 287: 847-857.
Noureddin BN, Seoud M, Bashshur Z, Salem Z, Shamseddin A, Khalil A. Ocular toxicity in low-dose tamoxifen: a prospective study. Eye 1999; 13: 729- 733.
Cauley JA, McTiernan A, Rodabough RJ, LaCroix A, Bauer DC, Margolis KL, et al. Statin use and breast cancer: prospective results from the Women’s Health Initiative. J Natl Cancer Inst 2006; 98: 700-707.
Mannucci P, Bettega D, Chantarangkul V, Tripodi A, Sacchini V, Veronesi U. Effect of tamoxifen on measurements of hemostasis in healthy women. Arch Intern Med 1996; 156: 1806-18100.
Decensi A, Robertson C, Rotmensz N, Severi G, Maisonneuve P, Sacchini V, et al. Effect of tamoxifen and transdermal hormone replacement therapy on cardiovascular risk factors in a prevention trial. Brit J Cancer 1998; 78: 572-578.
Tang R, Shields J, Schiffman J, Li H, Locher D, Hampton J, et al. Retinal changes associated with tamoxifen treatment for breast cancer. Eye 1997; 11: 295-297.
Brandes JL. The influence of estrogen on migraine. A systematic review. JAMA 2006; 295: 1824-1830. 16. Loder EW, Buse DC, Golub JR. Headache and combination estrogen-progestin oral contraceptives: integrating evidence, guidelines and clinical practice. Headache 2005; 45:224-231.
Bousser MG. Estrogens, migraine, and stroke. Stroke 2004; 35 ( suppl I ): 2652-2656.
MacGregor EA. Estrogen and attacks of migraine with and without aura. Lancet Neurol 2004; 3: 354- 361.
Pringsheim T, Gooren L. Migraine prevalence in male to female transsexuals on hormone therapy. Neurology 2004; 63: 593-594.
Chen Z, Yuhanna IS, Galcheva-Gargova Z, Karas RH, Mendelsohn ME, Shaul PW. Estrogen receptor alpha mediates the nongenomic activation of endothelial nitric oxide synthase by estrogen. J Clin Invest 1999; 103: 401-406.
Losel RM, Falkenstein E, Feuring M, Schultz A, Tillmann HC, Rossol-Haseroth K, et al. Nongenomic steroid action: controversies, questions, and answers. Physiol Rev 2003; 83: 965-1016.
Benedetto C, Allais G, Ciochetto D, De Lorenzo C. Pathophysiological aspects of menstrual migraine. Cephalalgia 1997; 17 (suppl 20): 32-34.
Colson NJ, Lea RA, Quinlan S, MacMillan J, Griffiths LR. Investigation of hormone receptor genes in migraine. Neurogenetics 2005; 6:17-23.
Colson NJ, Lea RA, Quinlan S, MacMillan J, Griffiths LR. The estrogen receptor 1 G594A polymorphism is associated with migraine susceptibility in two independent case/control groups. Neurogenetics 2004; 5: 129-133.
Puri V, Cui L, Liverman CS, Roby KF, Klein RM, Welch KM, et al . Ovarian steroids regulate neuropeptides in the trigeminal ganglion. Neuropeptides 2005; 39: 409-417.
Foldvary-Schaffer N, Harden C, Herzog a, Falcone T. Hormones and seizures. Cleve Clin J Med 2004; 71 (suppl 2): S11-S18.
Veliskova J. The role of estrogens in seizures and epilepsy: the bad guys or the good guys? Neuroscience 2006; 138: 837-844.
Zupanc ML. Antiepileptic drugs and hormonal contraceptives in adolescent women with epilepsy. Neurology 2006; 66 (suppl 3): S37-S45.
Peebles CT, McAuley JW, Moore JL, Malone HJ, Reeves AL. Hormone replacement therapy in a postmenopausal woman with epilepsy. Ann Pharmacother 2000; 34: 1028-1031.
Herzog AG, Klein P, Ransil BJ. Three patterns of catamenial epilepsy. Epilepsia 1997; 38; 1082-1088.
Rhodes ME, Frye CA. Progestins in the hippocampus of female rats have antiseizure effects in a pentylene tetrazole seizure model. Epilepsia 2004; 45: 1531-1538.
Rhodes ME, Frye CA. Actions at GABA A receptors in the hippocampus may mediate some antiseizure effects of progestins. Epilepsy & Behavior 2005; 6: 320-327.
Reddy DS, Kim HY, Rogawski MA. Neurosteroid withdrawal model of perimenstrual catamenial epilepsy. Epilepsia 2001; 42: 328-336.
Harden C, MacLusky NJ. Aromatase inhibition, testosterone, and seizures. Epilepsy & Behavior. 2004; 5: 260-263.
Kaminski RM, Marini H, Kim WJ, Rogawski MA. Anticonvulsant activity of androsterone and etiocholanolone. Epilepsia 2005; 46; 819-827.
Reddy DS. Testosterone modulation of seizure susceptibility is mediated by neurosteroids 3α-androstanediol and 17 ß-estradiol. Neuroscience 2004; 129: 195-207.
Meyer RP, Hagemeyer CE, Knoth R, Kaufmann MR, Volk B. Antiepileptic drug phenytoin enhances androgen metabolism and androgen receptor expression in murine hippocampus. J Neurochem 2006; 96: 460-472.
Ciampani M, Verrotti A, Chiarelli F. Sex hormones in patients with epilepsy-hormonal changes in epileptic men and women taking antiepileptics. Horm Metab Res 2005; 37:184-8
Leong KS, Foy PM, Swift AC, Atkin SL, Hadden DR, MacFarlane IA. CSF rhinorrhea following treatment with dopamine agonists for massive invasive prolactinomas. Clin Endocrinol (Oxf) 2000; 52: 43-49.
Jones SE, James RA, Hall K, Kendall-Taylor P. Opticchiasmal herniation- an uder recognized complication of dopamine agonist therapy for macroprolactinoma. Clin Endocrinol (Oxf) 2000; 53: 529-534.
Chuman H, Cornblath WT, Trobe JD, Gebarski SS. Delayed visual loss following pergolide treatment of prolactinoma. J Neuro-Ophtalmol 2002; 22: 102- 106.
Dorotheo EU, Tang RA, Bahrani HM, Schiffman JS, Bhatti MT, Lewis SB. Her vision was tied down. Surv Ophtalmol 2005; 50: 588-597.
Lamas C, Nunez R, Garcia-Uria J, Salas C, Saucedo G, Estrada J, et al. Malignant prolactinoma with multiple bone and pulmonary metastases. Case report. J Neurosurg 2004; 101 (1 suppl): 116-121.
Masago A, Ueda Y, Kanai H, Nagai H, Umemura S. Pituitary apoplexy after pituitary function test: a report of two cases and review of the literature. Surg Neurol 1995; 43:158-165.
Foppiani L, Piredda S, Guido R, Spaziante R, Giusti M. Gonadotropin-releasing hormone-induced partial emptysella clinically mimicking pituitary apoplexy in a womanwith a suspected non-secrteing macroadenoma. J Endocrinol Invest 2000; 23: 118-121.
Nagulesparan M, Roper J. Hemorrhage into the anterior pituitary during pregnancy after induction of ovulation with clomiphene. A case report. Br J Obstet Gynecol 1978; 85: 153-155.
Wakai S, Fukushima T, Teramoto A, Sano K. Pituitary apoplexy: its incidence and clinical significance. J Neurosurg 1981; 55: 187-193.
Matsuura I, Saeki N, Kubota M, Murai H, Yamamura A. Infarction followed by hemorrhage in pituitary adenoma due to endocrine stimulation test. Endocr J 2001; 48: 493-498.
Chuang CC, Chang CN, Wei KC, Liao CC, Hsu PW, Huang YC, et al. Surgical treatment for severe visual compromised patients after pituitary apoplexy. J Neurooncol 2006 Apr 28 { Epub ahead of print}.
Korotinsky S, Smadja P, Goland S, Somin M, Attali M, Zhornicky T, et al. Pituitary apoplexy after administration of heparin and isosorbide dinitrate. South Med J 2002; 95: 469-470.
Sibal L, Ball SG, Connolly V, et al. Pituitary apoplexy: a review of clinical presentation, management and outcome in 45 cases. Pituitary. 2004; 7: 157-163.
Semple PL, Webb MK, de Villiers JC, et al. Pituitary apoplexy. Neurosurgery. 2005; 56: 65-72.
Lee DH, Chung MY, Chung DJ, et al. Apoplexy of pituitary macroadenoma after combined test of anterior pituitary function. Endocr J. 2000;47:329-333.
Jácome-Roca A. Apoplejía hipofisiaria en un joven con giganto-acromegalia e hipogonadismo, informe de un caso. Univ Med 1979; 21: 23-27.
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