RELATIONSHIP BETWEEN MESIAL TEMPORAL SEIZURE FOCUS AND ELEVATED SERUMPROLACTIN IN TEMPORAL-LOBE EPILEPSY

We evaluated the relationship between mesial temporal seizure focus an d serum prolactin (PRL) in patients before and after they underwent an terior temporal lobectomy (ATL) for medically intractable temporal lob e epilepsy (TLE). These patients had a confirmed unilateral epileptoge nic focus in mesial temporal structures, a postictal rise in serum PRL 15 to 20 minutes after onset of complex partial seizures, and were re fractory for more than 2 years to antiepileptic drugs. Presurgical int erictal serum PRL levels were significantly elevated (16.47 +/- 0.85 n g/mL, n = 62) and declined after ATL to normal values (patients, 9.63 +/- 0.05 ng/mL, n = 54; normal subjects, 8.99 +/- 0.57 ng/mL, n = 52). Serial evaluations indicated that normalization was seen 3 months aft er surgery (9.42 +/- 1.22 ng/mL, n = 9). The postsurgical reduction in serum PRL was similar in men and women, in patients with epileptogeni c focus on either side of mesial temporal structures, and. was unaffec ted by antiepileptic medication. We conclude that PRL is elevated foll owing seizures and that a seizure focus in mesial temporal structures may exert a sustained excitatory influence on PRL release in patients with medically intractable TLE.