Serum prolactin for differentiating epileptic seizures in children
Abstract: Background Serum
prolactin level has been used as a marker to differentiate epileptic from
non-epileptic seizures in adults. Electroencephalogram (EEG) examination is the
primary diagnostic tool used to assess seizures. However, EEGs are quite
difficult to perform in children and have sensitivity of only 50%- 55%, with
96% specificity. Objective To assess the diagnostic potential of serum
prolactin level as an alternative tool for children for differentiating between
epileptic and non-epileptic seizures. Methods This diagnostic study was
performed between January 2013 and December 2013. Thirty patients aged 3 months
to 15 years with seizures and without fever who visited the Emergency
Department of Arifin Ahmad Hospital, Pekanbaru, Riau, were included. Blood
specimens were collected within 2 hours after seizure. Subjects underwent serum
prolactin measurements and EEG examinations. Results Fifteen subjects had
normal EEGs and 15 subjects had abnormal EEGs. Post-ictal serum prolactin
levels were significantly higher in the epileptiform EEG group. The mean serum
prolactin levels were 23.78 (SD 21.86) ng/mL and 10.57 (SD 5.62)ng/mL in
patients with epileptic and non-epileptic patients, respectively. Using a
prolactin cut-off point of 17.2 ng/mL, serum prolactin had a 73.3% sensitivity
and 93.3% specificity for differentiating between epileptic and non-epileptic
seizures. Conclusion Our findings suggest that serum prolactin level increases
after an epileptic seizure, but not after a non-epileptic seizure. Post-ictal
prolactin elevation within 2 hours may be useful in differentiating epileptic
seizures from non-epileptic seizures.
Author: Harry Mangunsong
Journal Code: jpkedokterangg150267