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Prolactin and cortisol levels in various paroxysmal disorders in childhood
1Department of Pediatrics, Carmel Hospital, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Insights
Elevated prolactin levels after seizures can help distinguish epileptic seizures from febrile seizures or syncope in children. Cortisol levels rise with all stressful events, not just epilepsy.
Area of Science:
- Pediatric Neurology
- Endocrinology
Background:
- Hormonal responses, particularly from the anterior pituitary, are crucial in understanding physiological reactions to neurological events in children.
- Differentiating between epileptic seizures and nonepileptic events like febrile seizures or syncope is clinically significant.
Purpose of the Study:
- To investigate and compare the postictal hormonal responses, specifically prolactin and cortisol, in children experiencing epileptic seizures versus nonepileptic events.
- To determine if prolactin levels can serve as a biomarker to differentiate epileptic seizures from febrile seizures and syncope.
Main Methods:
- Serum prolactin and cortisol levels were measured postictally in children with epilepsy, febrile seizures, syncope/breath-holding spells, nonspecific fever, and healthy controls.
- Statistical analysis (P < .01) was used to compare hormone levels between the different groups.
Main Results:
- Children with epilepsy showed significantly higher prolactin levels (26.5 +/- 3.3 ng/mL) compared to all other groups, including febrile seizures (13.2 +/- 1.0 ng/mL) and syncope (7.3 +/- 0.9 ng/mL).
- Serum cortisol levels were elevated non-specifically across epileptic seizures, febrile seizures, and fever, indicating a general stress response.
- Elevated prolactin levels (>15 ng/mL) were predominantly observed after epileptic seizures.
Conclusions:
- Postictal prolactin levels are significantly higher after epileptic seizures than after febrile seizures or syncope in children.
- Prolactin measurement may aid in distinguishing epileptic seizures from other seizure-like events.
- Cortisol elevation is a non-specific marker of stress in various pediatric events, including seizures and fever.
Abstract:
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 less than .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 (greater than 15 ng/mL) associated with seizures may help in differentiating epileptic from febrile seizures or syncope.