Serum prolactin levels after seizure and syncopal attacks

Loss of consciousness and falling are the key features of syncope. Common a ccompaniments include tonic and myoclonic muscle activity, eye deviations, automatisms, vocalizations and hallucinations that may render the distincti on from epileptic seizures difficult. The frequently increased levels of se rum prolactin (SPRL) were observed immediately after generalized and comple x partial seizures. Presumably, the hormone release is caused by the propag ation of epileptic activity, usually from the temporal lobe to the hypothal amic pituitary axis. Numerous reports have demonstrated that the post-ictal SPRL level may be used to differentiate between epileptic and syncopal, no n-epileptic attacks. In order to confirm the hypothesis, the SPRL levels we re measured in patients with compex partial seizures (CPS) and patients wit h vaso-vagal syncopal attacks (VVS). The SPRL levels were prospectively mea sured for each patient as soon as possible after the event (within 1 hour), then 1 hour after the first determination and finally blood was sampled 24 hours later. During the study period (18 months), 18 patients with CPS and 15 patients with WS were investigated in total. The mean values of SPRL le vels in both groups were increased immediately after the event (CPS group: 1142 +/- 305 mIU/l; VVS group: 874 +/- 208 mIU/l). The elevated SPRL levels were found in 14 (78%) patients immediately after CPS and in 9 (60%) patie nts immediately after WS. After examining the results of the present study we conclude that the elevated serum prolactin level after an epileptic atta ck is of no significant value in differential diagnosis between epileptic a nd vaso-vagal syncopal attacks.