Postictal serum prolactin and cortisol levels were measured in 37 children having either epilepsy, febrile seizure or syncopal attack and in 37 normal controls. Blood samples were obtained within 1.5 h following the seizure episode. All serum levels were compared between each group and the control groups. Significantly higher (P < 0.005) prolactin levels (56.64 +/- 34.78 ng/mL) were found in the epileptic group, compared to the levels in children with febrile seizures (21.72 +/- 12.92 ng/mL), syncope attacks (13.88 +/- 5.27 ng/mL) and the control group (14.32 +/- 5.05 ng/mL). In contrast, serum cortisol levels were non-specifically elevated in children with epilepsy, febrile seizures and syncopal attacks. Cortisol secretion appears to be non-specifically elevated in all stressful events. Elevated prolactin levels may be helpful in differentiating epilepsy from febrile seizures and syncope.