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General seizures revealing macro-adenomas secreting prolactin or prolactin and growth hormone in men

Farida Chentli1, Lina Akkache1, Katia Daffeur1

  • 1Department of Endocrine and Metabolic Diseases, Bab El Oued Hospital, 5 boulevard Said Touati, Algiers, 16000, Algeria.

Indian Journal of Endocrinology and Metabolism
|June 20, 2014
PubMed
Abstract

Insights

Epilepsy can be an initial symptom in men with large pituitary tumors (macroprolactinomas or somatolactotroph adenomas). Tumor reduction often resolves seizures, but radiotherapy may induce epilepsy.

Area of Science:

  • Neuroendocrinology
  • Neurology
  • Oncology

Background:

  • Epilepsy is a complex neurological disorder with diverse causes.
  • Pituitary tumors, particularly large ones, can rarely cause generalized seizures.
  • Limited research exists on epilepsy in male macroprolactinoma patients.

Purpose of the Study:

  • To investigate the frequency of epilepsy in men with macroprolactinomas or somatolactotroph adenomas.
  • To identify conditions associated with seizure onset and cessation in these patients.

Main Methods:

  • Retrospective analysis of 90 men with pituitary adenomas (>1 cm) secreting prolactin or both prolactin and growth hormone.
  • Inclusion of patient history, clinical exams, laboratory tests, and MRI scans.
  • Focus on identifying generalized seizures.

Main Results:

  • Eight cases (8.9%) of epilepsy were identified between 1992 and 2012.
  • Seizures were the primary reason for hospitalization in seven patients.
  • Median age was 33.75 years, median prolactin levels were 9,198 ng/ml, and median tumor height was 74 mm.
  • Temporal lobe invasion occurred in six patients.
  • Epilepsy resolved after tumor reduction (surgery or medical treatment) with no relapse during follow-up (1-20 years).
  • One patient developed epilepsy after radiotherapy due to treatment resistance.

Conclusions:

  • Epilepsy can be a presenting symptom of prolactinomas or somatolactotroph adenomas, especially those with suprasellar extension.
  • Radiotherapy for pituitary adenomas may precipitate epilepsy and should be considered cautiously before tumor debulking.
  • Effective tumor management through surgery or medication can lead to seizure remission.
Keywords:
Epilepsylarge prolactinomasmaleradiotherapy

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