To the Editor.
—In their fascinating pair of articles, Herzog et al1,2 document clinical and endocrinologic evidence of dysfunction in the hypothalamic pituitary circuit of a significant number of men and women diagnosed as having temporal lobe epilepsy (TLE). As they note, however, whether the relationship of these findings is to TLE specifically or to epilepsy in general (or to generalized epilepsy [GE]) cannot be demonstrated without study of other epileptic comparison groups. This has already been done by Toone et al3,4 who found clinical evidence of hyposexuality in males with epilepsy, but no differences between those with TLE and GE. Toone and his collaborators also found a strong relationship between hyposexuality in the male and anticonvulsant medication.The suggestion by Herzog et al1,2 that the appearance of TLE may be in response to endocrine dysfunction is particularly intriguing and is consistent with the enhanced incidence of
Stevens JR. Temporal Lobe Epilepsy: Response to Endocrine Dysfunction? Arch Neurol. 1987;44(8):796. doi:10.1001/archneur.1987.00520200004003
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