Endocrine Abstracts

Objective: To study epileptic seizures in patients with large and giant prolactinomas.

Patients and methods: The study group included 45 patients with large prolactinoma (more 36 mm in diameter) and 23 patients with giant prolactinoma (more than 60 mm in diameter). 55 men and 13 women aged 16–67 years (mean 39). Patients were followed by hormone measurements, magnetic resonance imaging (MRI), electroencephalogram (EEG) and endocrinological, psychopathological, neurologic examinations.

Results: Mean serum prolactin level ranged between 12 990 and 1 038 000 mU/l (mean 198 000 mU/l). Epileptic syndrome was revealed in 14 patients (21%): partial seizures with secondary generalization (64%), complex (28%) and simple (14%) seizures or their combinations. Seizures differed in structure depending on growth of the tumor. Partial seizures with secondary generalization were mostly revealed in patients with growth of adenoma to temporal region on left (50%) and right (14%). Complex partial seizures were revealed in patients with growth of the adenoma to temporal region on left (21%) and into the III ventricle (7%). Simple partial (psychosensory) seizures were in patients with growth of adenoma into diencephalic region (14%). Diagnosis of epileptic seizures was based on the detection of typical pathological patterns in EEG.

Conclusion: 21% patients with large and giant prolactinomas have epileptic syndrome. Structure of epileptic seizures depends on extension of the adenoma and intrusion in different regions of the brain.