**7. Conclusion**

Significant changes in sleep architecture of patients with epilepsy were observed, as lower effectivity of sleep together with higher amount of NREM S2 sleep and fewer REM sleep. These may negatively influence daytime vigility, mental abilities and also compensation of epilepsy.

It was also detected, that patients with generalized epilepsy have lower effectivity of sleep and patients with focal epilepsy have fewer deep sleep stages of NREM sleep.

Some tendency to elevated daytime sleepiness in the group of patients with temporal or temporoparietal localization of epileptic focus was proved.

We recommend awareness among clinicians of the comorbidity of epilepsy and sleep disorders as correct diagnostic and therapeutic approach may improve quality of life of patients.

### **8. Acknowledgement**

This article was published with support of UCB s.r.o, Slovakia.

#### **9. References**


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Significant changes in sleep architecture of patients with epilepsy were observed, as lower effectivity of sleep together with higher amount of NREM S2 sleep and fewer REM sleep. These may negatively influence daytime vigility, mental abilities and also compensation of

It was also detected, that patients with generalized epilepsy have lower effectivity of sleep

Some tendency to elevated daytime sleepiness in the group of patients with temporal or

We recommend awareness among clinicians of the comorbidity of epilepsy and sleep disorders as correct diagnostic and therapeutic approach may improve quality of life of

American Sleep Disorders Association: The clinical use of the Multiple sleep latency test.

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**7. Conclusion** 

epilepsy.

patients.

**8. Acknowledgement** 

0161-8105.

9580.

**9. References** 


**1. Introduction** 

2010)

**1.1 Regulation of female reproductive system** 

permanent cessation of ovarian function and menstruation.

Regulation of female reproductive system consists of very complex interactions between the hypothalamus, neurohypophysis and ovaries. Beginning from the embryologic stage, female reproductive system is regulated by the brain. Ovarian hormone production is supressed by the hypothalamo-hypophyseal control mechanism till the end of the childhood period when the puberty begins. During puberty, menstrual cyclicity and timely ovulation, which are the result of the precise integration within different components of the reproductive system, are achieved. After puberty, comes the reproductive period which generally lasts about 30-35 years. During reproductive period, from daily social behavior to sexual life and reproduction, many important issues depend on normal ovarian folliculogenesis and hormonogenesis. Menopause refers to the final menstrual period accompanying the

Gonadotropin releasing hormone receptor (GnRHR) is secreted from hypothalamus and delivered to the anterior pituitary via the hypophyseal portal circulation where it binds to the GnRHR on the surface of gonadotropes triggering the synthesis and secretion of the gonadotropins, follicle stimulating hormone (FSH) and luteinizing hormone (LH). In the female, LH stimulates the production of androgens by the thecal cells that surround the growing ovarian follicle. During the terminal stages of follicular growth, LH also drives the production of progesterone from the granulosa cells of the preovulatory follicle. FSH binds to receptors on the surface of ovarian granulosa cells stimulating the expression of aromatase enzymes that convert thecal androgens to estradiol. The Hypothalamushypophysis-gonadal (HPG) axis is subject to both positive feed-forward and negative feedback regulation at several levels. At the level of the hypothalamus, early recognition of the pulsatile nature of gonadotropin releasing hormone secretion led to the notion of a central ''pulse generator", the inherent oscillatory activity of which controls the secretory rhythm of GnRH neurons (Knobil, 1980). Hypothalamic pulse generator is extensively modulated by a multitude of higher level inputs including photoperiod, environmental stress, metabolic state and nutritional status, as well as various endocrine mediators. (Bliss,

**4** 

*Turkey* 

**The Impact of Epilepsy on** 

*Istanbul University, Cerrahpasa School of Medicine,* 

**Reproductive Functions** 

Cemal Tamer Erel and Onur Guralp

 *Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology* 

