Serum prolactin and cortisol concentrations after grand mal seizures.

Abstract

SUMMARY Serial serum prolactin and cortisol levels were measured in five patients after a grand mal seizure and in four volunteers with simulated seizures. Single levels were measured after a witnessed seizure in 26 patients and in a matched control group. Significant increase in both prolactin and cortisol levels occurred after seizures. The change in cortisol level may reflect a nonspecific stress response, but the increase in prolactin levels could not be accounted for on this basis, and probably indicates an alteration in hypothalamic neurotransmitter activity during the seizure. These findings may have clinical value in the diagnosis of epilepsy.Prolactin release from the anterior pituitary gland is thought to be controlled by release of neurotransmitter from the hypothalamus. Inhibition by dopamine' is important but noradrenaline2 and gamma aminobutyric acid (GABA)' may ailso inhibit prolactin release. The nature of the prolactin-releasing factor in mammals is uncertain, and the effect of 5-hydroxytryptamine (5-HT) on prolactin release in man is still unclear.46.Serum prolactin may, therefore, be considered as a peripheral marker of hypothalamic neurotransmitter activity. Many other factors are known to influence prolactin secretion, including stress7 and drugs.8 Electroconvulsive therapy has been shown to produce a marked rise in serum prolactin,9 and in a recent uncontrolled study a significant increase in prolactin levels was found 20 minutes after a grand mal convulsion.10 Paroxysmal discharges occur during grand mal seizures in major ascending and descending pathways concerned with consciousness and motor control, but involvement of the hypothalamus has not been studied. If a clearly defined rise in serum prolactin occurs after seizures this might have clinical applications in the assessment of patients with episodes of loss of consciousness of uncertain aetiology. As stress

Differential Response of Growth Hormone, Cortisol, and Prolactin to Seizures and to Stress

“…1 and 5) and, therefore, may be used as a baseline substitute. Our study confirms previous observations (Trimble, 1978;Abbott et al, 1980;Collins et al, 1983;Aminoff et al, 1984;Pritchard et al, 1985) indicating that cortisol and PRL concentrations increase in plasma within 60 rnin following a generalized convulsion. The magnitude of the hormonal response in our patients was similar to that reported by others.…”

Epileptic but Not Psychogenic Seizures Are Accompanied by Simultaneous Elevation of Serum Pituitary Hormones and Cortisol Levels

“…The half-life of 123 min for cortisol after the seizure in our pa tients with epileptic seizure is twice as high as that after a bolus injection of cortisol to healthy subjects, which is 66 min [13]. The increase in cortisol was less pronounced than that of prolactin and thyrotropin as has been noted else where [1].…”

“…Serum norepinephrine was lower in patients compared to healthy subjects (p<0.05). The simultaneous elevation of serum prolactin, thyrotropin, growth hor mone, and cortisol points to a central stimulation of the hypothalamic-pituitary axis during an epileptic seizure, but not during seizures of psychogenic origin.Following a grand mal or complex partial seizure most patients show a rise in serum prolactin levels [1,2,6,12,13,18,22,25,26,35,36]. Electroconvulsive treatment also eli cits in humans a rise in serum prolactin, adrenocortotropic hormone (ACTH), and thyrotropin [4,20,21,23].…”

Effect of Experimental Limbic Epilepsy on the Estrus Cycle and Reproductive Success in Rats

“…Seizure activity can cause an outpouring of prolactin in humans (Trimble, 1978;Abbott et al, 1980). Because previous experiments in which EEGs were recorded showed that seizure activity probably had stopped by the time the litters were born (Hawkins and Mellanby, 1987), such an impairment of prolactin secretion would have had to outlast the seizures by several weeks.…”