AbstractA 38 year old lady was admitted with history of dyspnea & paroxysmal events of variable duration. MRI Contrast of Brain performed in 2014 suggested microadenoma. She had irregular menstrual cycle & overnight video-EEG monitoring revealed complex partial seizures with secondary generalization. Serum prolactin levels at 3:41 PM were 5.27 ng/mL on the day of admission, at 4:53 AM on the next day it was 58.37 ng/mL. The repeat tests showed precision & prolactin at 12:25 PM repeat test on fresh sample was 12.48 ng/mL. The etiopathogenesis for isolated early morning peak level was thoroughly investigated and literature studies suggested nocturnal and diurnal variation with eightfold early morning peak in prolactin levels when associated with oligomenorrhea or neurological medication. This case was unique that there was an isolated eleven-fold rise in serum prolactin which is uncommon.
Keywords: Hyperprolactinemia; Nocturnal Variation; Microadenoma; Prolactin; Diurnal Variation.