The hormonal response of the anterior pituitary to various epileptic and nonepileptic events in children was studied. Postictal serum prolactin and cortisol levels were measured in 17 children with epilepsy, 23 with febrile seizures, and 10 with syncope or breath-holding spells. The levels were compared with those of 30 children with nonspecific fever, and 23 afebrile children served as control subjects. Significantly higher (P <.01) prolactin levels (26.5 ± 3.3 ng/mL, mean ± SEM) were found in the epileptic group, compared with levels in children with febrile seizures (13.2±1.0 ng/mL), fever (11.2±0.9 ng/mL), syncope (7.3±0.9 ng/mL), and the control group (7.9± 0.6 ng/mL). In contrast, serum cortisol levels were nonspecifically elevated in the epileptics and patients with febrile seizures or fever only. These findings suggest that elevated prolactin levels may be found after epileptic seizures and much less after febrile seizures, but not after breath-holding spells or syncopal events. Cortisol secretion appears to be nonselectively triggered by all stressful events, such as epileptic and febrile seizures, and fever. Elevated prolactin levels (>15 ng/mL) associated with seizures may help in differentiating epileptic from febrile seizures or syncope.
Serum Prolactin in Diagnosis of Epileptic Seizures
