PEDIATRICS Vol. 88 No. 3 September 1991, pp. 486-489
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Prolactin and Cortisol Levels in Various Paroxysmal Disorders in Childhood

Nathanel Zelnik MD1, Luna Kahana DSc2, Anat Rafael MSc2, Irit Besner MD1, and Theodore C. lancu MD1

1 The Department of Pediatrics and Pediatric Research Unit, Carmel Hospital, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
2 The Institute of Endocrinology, Carmel Hospital, Kupat-Holim, Haifa, Israel

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 <.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 (>15 ng/mL) associated with seizures may help in differentiating epileptic from febrile seizures or syncope.

Key Words: prolactin • cortisol • epilepsy • febrile convulsions • syncope

Submitted on June 1, 1990
Accepted on September 11, 1990


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