Endocrine Abstracts

Objectives: Prolactinomas can extend out of the sella turcica and invade surrounding structures and the brain. The prevalence and natural history of epilepsy at presentation of macroprolactinoma is not clear.

Methods: The case records of 62 patients (34 male) with macroprolactinoma attending a neuroendocrine clinic were studied.

Results: Four patients (6.5%, 3 males) had experienced epileptic seizures before the diagnosis of macroprolactinoma was made. The details at diagnosis are shown below:

One patient (42 M) had simple partial seizures which was undiagnosed for 7 years prior to the diagnosis of macroprolactinoma. Another (51 m) had monthly, complex partial seizures and was on antiepileptic treatment for 23 years. A CT scan in 1982 was reported as ‘normal’ but MRI scan in 2004 showed massive, invasive prolactinoma. His seizures stopped with bromocriptine treatment although MRI appearance is unchanged.

Conclusion: Patients with macroprolactinomas should be questioned about possible epilepsy especially partial seizures, which may be present for many years before diagnosis. Dopamine agonist treatment may reduce seizure frequency.