Abstracts

Rationale: Rising in serum prolactin (PRL) has never been studied in relation to different characters of seizures under video-EEG monitoring. This study aims to assess the correlation between post-ictal PRL levels and seizure details namely semiology, duration of seizure, seizure-free interval and site of epileptogenic zone. Methods: Serum PRL levels were measured in 89 seizures (all were focal seizures with 24 secondary GTCs and 44 auras) from 55 patients (30 females, 25 males) with medically intractable epilepsy who underwent long-term video-EEG monitoring. Blood samples were collected at 30 minutes, 1 hour, and 6 hours after seizures. A 6-hour PRL level was used as baseline for each seizure. PRL levels more than 2 folds above baseline were considered as elevation. Seizure details were analyzed from video-EEG recordings and correlated with PRL levels. Results: Logistic regression analysis revealed significant increase of PRL in seizures with aura (p=0.018, OR(95%CI); 3.11(1.22-7.96) at 30 minutes; p=0.027, OR(95%CI); 2.63(1.11-6.22) at 1 hour post-ictally), GTC (p=0.015, OR(95%CI); 6.60(1.44-30.30) at 30 minutes; p=0.027, OR(95%CI); 2.95(1.13-7.67) at 1 hour post-ictally), tonic seizures (p=0.013, OR(95%CI); 2.90(1.25-6.71) at 1 hour post-ictally), seizures with post-ictal confusion (p=0.013, OR(95%CI); 0.30(0.11-0.77) at 30 minutes post-ictally), EEG duration (p=0.025, OR(95%CI); 2.57(1.12-5.87) at 30 minutes post-ictally) and in females compared to males (p=0.006, OR(95%CI); 0.18(0.05-0.61) at 30 minutes; p=0.018, OR(95%CI); 0.26(0.08-0.79) at 1 hour post-ictally). Most correlations were stronger at 30 minutes than at 1 hour after seizures. Multiple logistic regression analysis revealed that only aura had significant correlation with elevated serum PRL at 30 minutes after seizures (p=0.005, OR(95%CI); 11.24 (2.08-60.69)). No correlation was found between elevated PRL and the following seizure characters: eye deviation, version, dystonic posturing, clonic seizure, automatism, impaired consciousness, clinical duration, seizure-free interval or the site of epileptogenic zone. Conclusions: Our findings suggested that elevation of post-ictal serum PRL was related to seizures with long duration and female gender.