Factors Affecting Interictal Serum Prolactin Level of Male Epileptics with Complex Partial Seizures Involving Temporal Lobe Clinically.
Abstract number :
2.160
Submission category :
Year :
2001
Submission ID :
321
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
O-Y. Kwon, MD, PhD, Neurology, Gyeongsang National University College of Medicine, Jinju, Gyeongnam, Korea; Y-H. Lee, MD, Neurology, Gyeongsang National University College of Medicine, Jinju, Gyeongnam, Korea; K-S. Lee, MD, Neurology, Gyeongsang National
RATIONALE: Postictal measurement of serum prolactin is a useful diagnostic tool to differentiate epileptic seizure from psychogenic seizure. Effects of intractability of complex partial seizures (CPSs) on interictal serum prolactin level (ISPL) are not known. This study tested whether intractability of CPSs of temporal lobe increases ISPL and investigated effects of other factors on ISPL.
METHODS: Forty-one male epileptics older than 16 years whose CPSs showed motion arrest and vacant staring were selected. To exclude CPSs confined to frontal lobe, patients with CPSs showing brief duration and no postictal confusion were excluded. Patients with other diseases affecting prolactin level, diffuse brain lesion, or developmental delay were excluded. Minimum disease duration was 1 year. Interictal blood samples from patients were taken at morning before breakfast, and ISPL was measured. Brain magnetic resonance imaging (MRI) was performed in 34 patients, brain computed tomography was used for the other patients. Patients were divided into paired groups according to intractability, secondary generalization (SG), duration of disease (DD), seizure frequency (SF), polytherapy of AED (PT), hippocampal sclerosis in MRI (HS), and interictal epileptiform discharge (IED). ISPL was compared between paired groups using Mann-Whitney test. Patients seizure free for more than 6 months and without seizure in the past 3 months were considered treatable epileptics.
RESULTS: Of the 41 patients in this study, ISPL of intractable patients (11.43 1.25 [SEM] ng/ml, n = 23) was higher than treatable patients (9.67 1.52, n = 18), but there was no statistical significance (P = 0.253). ISPL of patients with SG was significantly higher (11.58 1.10, n = 33) than patients without SG (6.84 1.39, n = 8; P = 0.049). ISPL of patients with HS was significantly lower (4.96 1.12, n = 4) than patients without HS (12.46 1.18, n = 30; P = 0.015). DD, SF, PT, and IED did not make significant changes in ISPL (P [gt] 0.05).
CONCLUSIONS: Although repetitive ictal spreads in the limbic system may irritate the hypothalamic-pituitary axis, intractability of epilepsy with clinically determined CPSs of temporal lobe did not significantly elevate ISPL. Therefore, ISPL cannot be used as biochemical marker of tractability of CPSs involving temporal lobe. However, evidence suggests SG of CPSs may increase ISPL, which implies more widespread robust activation of limbic structures may be needed to elevate ISPL.