Prolactin in partial epilepsy: An indicator of limbic seizures

Abstract

A study was performed to evaluate changes in serum prolactin levels after simple and complex partial seizures, and to identify which specific anatomical structures must be involved in seizures for postictal elevation of prolactin levels to occur. Seventy-eight seizures were studied in patients with electrodes implanted bilaterally into amygdala, hippocampus, hippocampal gyrus, and frontal sites. All 38 complex partial seizures had bilateral limbic ictal discharges, and each was followed by a significant increase in prolactin concentration (mean peak, 50.8 ng/ml; range, 16.0 to 150.0 ng/ml). Eight of 10 simple partial seizures with unilateral high-frequency regional limbic discharges were followed by prolactin elevation (mean peak, 28.2 ng/ml; range, 13.4 to 44 ng/ml). Thirty simple partial seizures with other ictal limbic discharges or without limbic discharges were not followed by an elevated prolactin level. The data indicate that serum prolactin levels always rise after complex partial seizures involving the temporal lobes, and rise after certain simple partial seizures involving limbic structures. Thus, measurement of the prolactin level can help identify which simple partial seizures involve mesial temporal lobe structures. Limbic structures serve to trigger prolactin release, which may depend upon spread of the seizure to subcortical structures.

Methodologic Validity Of Patient’s History In Establishing The Diagnosis Of Epileptic Attacks

“…Hyperprolactinemia are frequently encountered especially in GTC and CP seizures. However absence of hyperprolactinemia doesn't have diagnostic value (18,19). In accordance with literature, in our cases with epileptic seizures increases in blood prolactin levels were observed.…”

Interictal EEG discharges, reproductive hormones, and menstrual disorders in epilepsy

“…4,5 The unusually frequent occurrence of reproductive endocrine disorders and reproductive dysfunction among women with TLE 6,7 raises the consideration that recurrent or persistent interictal epileptiform disruption of temporolimbic activity may lead to chronically altered hypothalamopituitary regulation of gonadal secretion and promote the development of reproductive endocrine disorders. 8,9 The observation in women that left-sided TLE (LTLE) may be associated with polycystic ovarian syndrome (PCOS) and right-sided TLE (RTLE) may be associated with hypothalamic amenorrhea (HA, hypogonadotropic hypogonadism), moreover, suggests a lateralized asymmetry in this possible effect.…”

Hormon- und Sexualstörungen bei Epilepsie

“…Klinische Studien legen nahe, dass eine temporolimbische Epilepsie mit verändertem Gonadotropin-Response auf eine GnRH-Infusion unabhängig von AED-Gebrauch assoziiert ist [55]. Epileptiforme Entladungen bei Männern sind von einer akuten Prolaktinerhöhung begleitet [56] und können auch von akuten Veränderun-gen der LH-Sekretion begleitet sein [6]. Quigg et al [57] [4,63].…”