Alteraciones del desarrollo físico y sexual en varones prepúberes y púberes con epilepsia, Hospital Universitario San Vicente de Paúl, Medellín, Colombia, 2005-2006.

Background: Diverse endocrine and sexual alterations have been described in adults and pubertal women with epilepsy. There are few studies of these disorders in pubertal males, none of them in Colombia. Objectives: To establish the frequency of alterations of physical and sexual development in prepubertal and pubertal males with epilepsy and to explore its association with the use of antiepileptic drugs and with the clinical, electroencephalographic and imaginological features of the disease. Methods: Twenty-nine epileptic males between 8 and 18 years of age were evaluated. They were not receiving steroids, and none of them had either moderate or severe mental retardation, cerebral palsy or endocrine dysfunctions. Data were obtained from a structured interview with their parents, from the medical registrations and by evaluating the physical and sexual maturation (anthropometric measures, Tanner, penile length and testicular volume). Results: There were alterations of the sexual development in 6.9% or the patients, and of the physical development in 31%, namely: overweight in 20.7%, obesity in 6.9% and short stature in 13.8%. Those taking valproate had higher rates of overweight (50% vs 5.3%, p = 0.01), and lower testicular volume (3.25 vs 5.5 mL, p = 0.08) in comparison with the ones that did not use it. Patients with short stature had had longer duration of the epilepsy as compared to those with normal stature (9.75 vs 4.0 years, p = 0.02). Conclusion: Prepubertal and pubertal males with epilepsy presented high rates of overweight and obesity associated with the use of valproate, and of short stature associated with longer duration of their illness; such alterations should be controlled during treatment.