Endocrine Abstracts

We present the case of a girl with rapidly progressing central precocious puberty, CPP. The young girl presented with consonant rapidly progressive puberty and onset of menarche. She had onset of breast budding at 7 years 11months, menarche at 8 years 2 months, with significant growth spurt. Periods continued every 3 weeks. A Brain MRI demonstrated a dysplastic lesion of her tectal plate. She underwent treatment with Gonadotropin releasing hormone analogues to suppress puberty. The girl went on to develop strange episodes at night when puberty was not suppressed. A EEG demonstrated features consistent with Paniyatopoulous syndrome. After commencing gonadotropin releasing hormone analogues, the strange episodes resolved. However they reoccurred prior to her next injection, associated with elevated LH. When injection frequency was increased, seizures resolved. Puberty is well known to be both a trigger for pre-existing epilepsy syndromes and a time when new seizures can emerge, presumably due to hormonal influences on neurobiology. With this case we encourage the clinician to be vigilant for seizures in patients with precocious puberty.