Plasma prolactin concentrations following epileptic and pseudoseizures.

Collins, William; Lanigan, O.; Callaghan, N.

doi:10.1136/jnnp.46.6.505

Cited by 70 publications

(32 citation statements)

References 4 publications

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“…This is in contrast to previous studies showing high baseline PRL levels in epileptic patients [1,2]. Since our patients were newly diagnosed and not taking anti-epileptics, the difference could result from the long duration of epilepsy and/or the anticonvulsant medication.…”

Section: Discussioncontrasting

confidence: 82%

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Prolactin levels in febrile and afebrile seizures

et al. 1995

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Transient hyperprolactinaemia has been reported to follow unprovoked seizures, a finding proposed to be useful in the differential diagnosis of epilepsy. There is also evidence that patients with unprovoked seizures may have high baseline prolactin levels, which could be of value in detecting those predisposed to epilepsy after a first convulsive attack. The purpose of this study was to examine whether prolactin levels are elevated: (1) postictally in febrile seizures and (2) interictally in afebrile seizures. In 17 children with simple febrile seizures, mean postictal prolactin value (370 +/- 160 mU/l, mean +/- SD) was significantly higher (approximately 0.001) than the mean baseline value of 18 seizure-free controls (202 +/- 136 mU/l). The mean baseline prolactin values were not significantly different: (1) in ten children with afebrile versus ten seizure-free controls and (2) in 18 children with febrile seizures associated with high risk for subsequent afebrile seizures versus 23 children with febrile seizures but unlikely to suffer from afebrile seizures. CONCLUSION. Postictal prolactin levels may be a useful marker of recent febrile seizures, while baseline prolactin levels do not appear to have any prognostic significance in afebrile seizures.

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Section: Discussioncontrasting

confidence: 82%

“…In addition to the postictal hyperprolactinaemia, it has been proposed that patients with epilepsy may have high interictal PRL levels [2]. Confirmation of this suggestion could be of great clinical value e.g.…”

Section: Introductionmentioning

confidence: 97%

Prolactin levels in febrile and afebrile seizures

et al. 1995

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“…In life, tonic-clonic and complex partial seizures are associated with rises of serum prolactin of the order of two to 12-fold above the upper limit of the normal range, and the peak levels usually occur 15-20 min after seizures (8,15,(34)(35)(36), although in some studies, elevated prolactin levels have been reported 5 min after a seizure (6). Thus, even if seizures always occur terminally in SUDEP, the lack of marked rises in serum prolactin in this study may be because there was insufficient time for prolactin to rise before cardiac standstill.…”

Section: Discussionmentioning

confidence: 99%

Prolactin Levels in Sudden Unexpected Death in Epilepsy

Opeskin

Clarke²,

Berkovic

2000

Epilepsia

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- Summary:Purpose: To assess serum prolactin levels in sudden unexpected death in epilepsy (SUDEP) and control groups to test the hypothesis that if seizures occur routinely as a terminal event in SUDEP, then raised prolactin levels may be an indicator of terminal seizure.Methods: Blood was taken for measurement of prolactin levels from subjects with SUDEP and three control groups. The control groups were those with epilepsy dying from causes other than epilepsy (e.g., ischemic heart disease or injuries), physiologically stressed individuals without epilepsy (they were admitted to the hospital after an acute illness and died after several hours to 3 days), and nonepileptic rapid deaths (these people collapsed suddenly and died at the scene). In the SUDEP group, evidence for terminal seizure was considered to be at least one of the following: body found half on, half off the bed, or urinary incontinence at the scene, or bitten lips or tongue at autopsy.The majority of sudden unexpected deaths in epilepsy (SUDEP) are unwitnessed, and in the absence of a better explanation, death is believed to be the result of a seizure. Clinical evidence for terminal seizure is found in up to about a third of cases (1-5), but whether seizures (either witnessed or unwitnessed) always precede SU-DEP is unknown.Serum prolactin has been observed to increase after generalized tonicklonic seizures (6-10) and complex partial seizures (8,ll-16), and the mechanism by which seizures are proposed to cause prolactin elevation involves propagation of the electrical discharge to the hypothalamus, thereby influencing prolactin release (16). Generally serum prolactin does not rise after simple partial or pseudoseizures (8,9,15,17,18 Results: There was evidence for terminal seizure at the scene or at autopsy in four of the 10 SUDEP cases. Serum prolactin levels were not significantly increased in the SUDEP group compared with the controls. None of the SUDEP subjects, including those with clinical evidence of a terminal seizure, had high prolactin levels characteristic of those observed after seizures in living subjects.Conclusions: Prolactin levels are not raised in SUDEP, even if there is evidence of terminal seizure. As prolactin takes 15-20 min to peak after a seizure in life, there may be insufficient time for a prolactin increase to occur in SUDEP. Thus prolactin levels cannot be used to determine if a deceased individual with epilepsy had a seizure or to answer the broad question whether SUDEP is always associated with a terminal seizure. Key Words: Prolactin-Epilepsy-Sudden unexpected death.The purpose of this study was to examine prolactin levels in SUDEP and control groups. If prolactin was consistently increased in SUDEP cases, but not in controls, then we would infer that terminal seizui-es had occurred in the SUDEP group.

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“…Modern neuroimaging, especially MRI, has become standard part of the presurgical evaluation. The detection of increased serum prolactin (PRL) 15 to 30 minutes after the seizures is a relatively sensitive but not pathognomonic test [8,9]. The level of prolactin rises two to three times above the baseline levels in 80% to 90% of patients with generalized tonic-clonic seizures (GTCS) and 40% to 60% of patients with CPS [10,11].…”

Section: Psychiatric Epidemiology and Diagnosismentioning

confidence: 99%

The relationship of psychiatric illnesses and seizures

Tsopelas

Saintfort

Fricchione

2001

Curr Psychiatry Rep

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The relationship between epilepsy and behavioral disturbances has been a subject of controversy since the 19th century. Affective changes may occur prior, during, or after the ictal discharge. Depression is the most prevalent comorbidity. Anxiety, panic attacks, and pseudoseizures may resemble complex partial seizures, and their diagnosis and treatment may be confusing, even to experienced clinicians. Epilepsy-related psychosis is less common, manifesting occasionally with symptoms that are indistinguishable from schizophrenia. There is no clear evidence of a distinct "epileptoid" personality, and interictal violence is extremely rare. Pharmacologic treatment with anticonvulsants remains the cornerstone of treatment. In case of psychiatric comorbidities or refractory seizures, the diagnosis should be re-examined.

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Plasma prolactin concentrations following epileptic and pseudoseizures.

Abstract: Patients and methodsPlasma prolactin was estimated following thirty-six seizures in thirty-five patients. All patients were in-patients at the time of the study. They were divided into three groups:-(a) Generalised seizures. There were eighteen patients [ten male, eight female: mean age

Cited by 70 publications

References 4 publications

Prolactin levels in febrile and afebrile seizures

Prolactin levels in febrile and afebrile seizures

Prolactin Levels in Sudden Unexpected Death in Epilepsy

The relationship of psychiatric illnesses and seizures

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