Prolactin levels in febrile and afebrile seizures

Abstract

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.

Serum Prolactin Level in Children with Febrile Seizure and Epileptic Seizure; Comparative Study

“…They found signifi cantly higher serum PL levels in the ES group. In typical FS, sub-clinical electrical activity does not exist, since the after-discharges are less intense and transient to project to the ventromedial hypothalamus, whereas, conditions mimicking seizures completely lack electrical discharges, which accounts for lack of PL elevation in conditions mimicking seizures 16 . In a study conducted by Banerjee et al 2 , 80% of children with GTCS and 60% with CPS had elevated serum PL level.…”

Does serum prolactin indicate the presence of seizure in the emergency department patient?

“…Fein in a study of 35 children noted a PPV of 65 % and NPV of 76 % in the diagnosis of tonic-clonic seizures [3]. Likewise, hyperprolactinemia has been reported to follow febrile seizures, as well as noting an 83 % increase from baseline of 202 to 370mU/l in this clinical setting [4]. Interestingly, there seems to be a tachyphylaxis-like response with depletion of the releasable protein.…”

Seizure duration may increase thyroid-stimulating hormone levels in children experiencing a seizure

“…5 Cortisol and prolactin levels were elevated in patients during the postictal period compared with control groups. 15,16 One study suggested that transient elevation of prolactin levels can differentiate an epileptic seizure from a nonepileptic movement that resembles seizure. 17 Seizure causes a significant and sustained elevation of thyrotropin releasing hormone (TRH) in specific extrahypothalamic rat brain regions related to epileptic foci such as the amygdala, hippocampus, pyriform cortex, and anterior cortex.…”