To the Editor.—
The report by Herzog and colleagues, "Neuroendocrine Dysfunction in Temporal Lobe Epilepsy" (Archives 1982;39:133-135), offers a potential neuroendocrinologic basis for impaired fertility in epileptic women1 and the frequent occurrence of hyposexuality—primarily erectile dysfunction—in men with temporal lobe epilepsy (TLE).2 We would be interested to know whether the patient who had an elevated serum prolactin level had recently experienced a seizure. Although we agree that interictal prolactin studies are normal in this clinical population, we found postictal hyperprolactinemia after complex partial seizures in all cases studied3; thus, the temporal relationship between serum prolactin determinations and the occurrence of seizures is critical. Although the clinical consequences of episodic hyperprolactinemia are uncertain, impotence and decreased libido are the most common accompaniments of sustained hyperprolactinemia in men.4 Further studies of prolactin secretion in TLE seem warranted.Using an intravenous (IV) bolus of luteinizing hormone-releasing hormone (LH-RH) in
Pritchard PB, Wannamaker BB, Sagel J, DeVillier C. Endocrine Dysfunction in Temporal Lobe Epilepsy. Arch Neurol. 1982;39(12):786–787. doi:10.1001/archneur.1982.00510240048018
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