Serum prolactin levels are elevated also after pseudo-epileptic seizures

Area of Science:

• Neurology
• Clinical Chemistry

Background:

• Distinguishing epileptic seizures from pseudoseizures is clinically challenging.
• Serum prolactin levels have been proposed as a biomarker for epileptic seizures.

Purpose of the Study:

• To evaluate the diagnostic accuracy of repeated serum prolactin measurements in differentiating epileptic seizures from pseudoseizures.
• To assess the sensitivity, specificity, and predictive values of prolactin level changes.

Main Methods:

• Prospective study measuring serum prolactin at 15 minutes and 2 hours post-event in patients with epilepsy and pseudoseizures.
• Analysis included absolute maximal prolactin levels and relative rise in blood levels.
• Diagnoses were confirmed independently of prolactin measurements, with EEG corroboration in most cases.

Main Results:

• A statistically significant rise in prolactin was observed in both epilepsy and pseudoseizure groups.
• However, considerable intra-patient variations in prolactin levels were noted with repeated measurements.
• The sensitivity for detecting pseudoseizures using maximal prolactin rise was low (20%), with a negative predictive value of 40%.

Conclusions:

• Serum prolactin measurements demonstrate limited discriminative power between epileptic and pseudo-epileptic seizures.
• The variability and low predictive values question the clinical utility of prolactin testing for this diagnostic purpose.