Epileptic but Not Psychogenic Seizures Are Accompanied by Simultaneous Elevation of Serum Pituitary Hormones and Cortisol Levels

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Abstract
The circadian rhythm of serum prolactin was determined in 12 patients with seizures, and 28 age- and sex-matched healthy subjects (14 men and 14 women). Blood was also collected every 15 min for 2 h immediately after a simultaneously video/EEG-documented epileptic (6 patients) and psychogenic seizure (5 patients) for the determination of prolactin, thyrotropin, growth hormone, cortisol, melatonin, catecholamines and serotonin. During the seizure-free interval, the circadian profile of serum prolactin was lower in female patients than in healthy women. Serum prolactin, thyrotropin, growth hormone, and cortisol were increased postictally, followed by a decrease, after a grand mal or complex partial seizure, but not after a psychogenic seizure in comparison to baseline serum hormone levels obtained during the same time on a seizure-free day. During the seizure and for 2 h afterwards, blood serotonin, serum melatonin, dopamine, and epinephrine did not alter and were within the reference limits of healthy subjects. Serum norepinephrine was lower in patients compared to healthy subjects (p < 0.05). The simultaneous elevation of serum prolactin, thyrotropin, growth hormone, and cortisol points to a central stimulation of the hypothalamic-pituitary axis during an epileptic seizure, but not during seizures of psychogenic origin.