Chentli Farida, Akkache Lina, Daffeur Katia, Azzoug Said
Department of Endocrine and Metabolic Diseases, Bab El Oued Hospital, 5 boulevard Said Touati, Algiers, 16000, Algeria.
Indian J Endocrinol Metab. 2014 May;18(3):361-3. doi: 10.4103/2230-8210.131185.
Epilepsy is a heterogeneous condition with numerous etiologies. Pituitary tumors are rarely responsible for generalized convulsions except when they are very large. Apart from anecdotic cases, only one study concerning epilepsy frequency in male macroprolactinomas is available in Medline. Our aim was to analyze epilepsy frequency and conditions under which seizures appear and disappear in men harboring macroprolactinomas or somatolactotroph adenomas.
We retrospectively analyzed 90 men with macro-adenomas (>1 cm) secreting prolactin (PRL) (n = 82) or both PRL and growth hormone (n = 8) to look for generalized seizures. We took into account familial and personal medical history, clinical examination, routine and hormonal analyzes, and radiological assessment based on cerebral magnetic resonance imaging.
Between 1992 and 2012, we collected eight cases (8.9%): Seven were hospitalized for recent generalized seizures; one had epilepsy after conventional radiotherapy given in 1992 because of neurosurgery failure and resistance to bromocriptine. Their median age was 33.75 years (22-58), median PRL was 9,198 ng/ml and median tumor height was 74 mm (41-110). The temporal lobe was invaded in six cases. After tumor reduction, epilepsy disappeared and never relapsed after a follow-up varying between 1 and 20 years.
Epilepsy, which is a life-threatening condition, can be the first presentation in men with prolactinomas or somatolactotroph adenomas, especially those involving the supra sellar area, and the brain. Convulsions can also appear after radiotherapy. That one should be avoided, if possible, before tumor reduction by surgery or medical treatment.
癫痫是一种病因众多的异质性疾病。垂体瘤很少导致全身性惊厥，除非瘤体非常大。除个别病例外，医学文献数据库（Medline）中仅有一项关于男性大泌乳素瘤癫痫发生率的研究。我们的目的是分析患有大泌乳素瘤或生长激素泌乳素瘤的男性癫痫的发生率以及癫痫发作和消失的情况。
我们回顾性分析了90例分泌泌乳素（PRL）（n = 82）或同时分泌泌乳素和生长激素（n = 8）的大腺瘤（>1 cm）男性患者，以寻找全身性癫痫发作。我们考虑了家族和个人病史、临床检查、常规和激素分析以及基于脑磁共振成像的放射学评估。
在1992年至2012年期间，我们收集到8例（8.9%）：7例因近期全身性癫痫发作住院；1例因1992年神经外科手术失败且对溴隐亭耐药接受常规放疗后发生癫痫。他们的中位年龄为33.75岁（22 - 58岁），中位泌乳素水平为9198 ng/ml，中位肿瘤高度为74 mm（41 - 110 mm）。6例颞叶受侵。肿瘤缩小后，癫痫消失，随访1至20年未复发。
癫痫是一种危及生命的疾病，可以是泌乳素瘤或生长激素泌乳素瘤男性患者的首发症状，尤其是那些累及鞍上区域和脑部的患者。放疗后也可能出现惊厥。在通过手术或药物治疗使肿瘤缩小之前，应尽可能避免放疗。
