Serum prolactin for differentiating epileptic seizures in children

  • Harry Mangunsong Department of Child Health, University of Riau Medical School, Arifin Ahmad Hospital, Pek
Keywords: prolactin, EEG, epileptic seizures

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.

References

Fisher RS, van Emde Boas W, Blume W, Elger C, Genton P, Lee P, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005;46:470-2.

Forsgren L. Incidence and prevalence. In: Wallace SJ, Farrell K,eds. Epilepsy in children, 2nd edn. London: Arnold;2004. p.21–5.

Oliviera SN, Rosado P. EEG interictal-sensitivity and specificity of the diagnosis of epilepsy. Acta Med Port. 2004;17:465-70.

Chen DK, So YT, Fisher RS. Use of serum prolactin in diagnosing epileptic seizures: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2005;65:668-75.

Pack A. Effects of treatment on endocrine function in patients with epilepsy. Curr Treat Options Neurol. 2005;7:273-80.

Trimble MR. Serum prolactin in epilepsy and hysteria. Br Med J. 1978;2:1682.

Macooie AA, Pashapoor N, Yekta Z, Karamyar M. Serum prolactin level after febrile seizure versus epileptic seizure in 6-month-old to 5-year-old children. Iran J Med Sci. 2009;34:177-80.

Cuthill FM, Espie CA. Sensitivity and specificity of procedures for the differential diagnosis of epileptic and non epileptic seizures: a systematic review. Seizure. 2005;14:293-303.

Cragar DE, Berry DT, Fakhoury TA, Cibula JE, Schmitt FA. A review of diagnostic techniques in the differential diagnosis of epileptic and nonepileptic seizures. Neuropsychol Rev. 2002;12:31-64.

Siniscalchi A, Gallelli L, Mercuri NB, De Sarro G. Serum prolactin levels in repetitive temporal epileptic seizures. Eur Rev Med Pharmacol Sci. 2008;12:365-8.

Vukmir RB. Does serum prolactin indicate the presence of seizure in the emergency department patient? J Neurol. 2004;251:736-9.

Dirik E, Sen A, Anal O, Cevik NT. Serum cortisol and prolactin levels in childhood paroxysmal disorders. Acta Paediatr Jpn. 1996;38:118-20.

Sifianou P, Mengreli C, Makaronis G, Pantelakis S. Prolactin levels in febrile and afebrile seizures. Eur J Pediatr. 1995;154:925-7.

Ehsan T, Fisher RS, Johns D, Lukas RJ, Blum D, Eskola J. Sensitivity and specificity of paired capillary prolactin measurement in diagnosis of seizures. J Epilepsy. 1996;9:101-5.

Alving J. Serum prolactin levels are elevated also after pseudo-epileptic seizures. Seizure. 1998;7:85-9.

Banerjee SH, Paul P, Talib VJ. Serum prolactin in seizure disorders. Indian Pediatr. 2004;41:827-31.

Published
2015-10-01
How to Cite
1.
Mangunsong H. Serum prolactin for differentiating epileptic seizures in children. PI [Internet]. 1Oct.2015 [cited 26Apr.2024];55(5):273-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/49
Received 2016-02-01
Accepted 2016-02-01
Published 2015-10-01