Seizure laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Revision as of 14:24, 30 October 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Overview
The laboratory tests for patients with seizure may include checking for: hypoglycemia, hyponatremia, uremia, and drug intoxication, and levels of ammonia, creatine kinase (CK), lactate, and prolactin. Elevated prolactin level may be helpful in differentiating generalized tonic-clonic or complex partial seizure from psychogenic nonepileptic seizures, only if the patient’s prolactin level is measured 10 to 20 minutes after a suspected seizure event. Analysis of the serum prolactin level is not effective in distinguishing a seizure from syncope. No conclusion could be established regarding serum prolactin changes following status epilepticus, repetitive seizures, and neonatal seizures.
Laboratory Findings
The chemical panel and laboratory tests for patients with seizure may include checking for:[1]
- Hypoglycemia
- Hyponatremia
- Uremia
- Drug intoxication
- Ammonia levels
- Creatine kinase (CK) levels
- Lactate levels
- Prolactin levels
Serum Prolactin Level
- A study found that:[2]
- If the serum prolactin level is more than three times the baseline (taken within one hour of the event and in the absence of test modifiers):
- The patient is nine times more likely to have had a generalized tonic-clonic seizure (GTCS) compared to a pseudoseizure, and five times more likely to have had a GTCS compared to a nonconvulsive syncope.
- If the serum prolactin level is more than three times the baseline (taken within one hour of the event and in the absence of test modifiers):
- Another study found that:[3]
- Elevated prolactin level may be helpful in differentiating GTCS or complex partial seizure from psychogenic nonepileptic seizures, only if the patient’s prolactin level is measured 10 to 20 minutes after a suspected seizure event (grade B).
- Analysis of the serum prolactin level is not effective in distinguishing a seizure from syncope.
- No conclusion could be established regarding serum prolactin changes following status epilepticus, repetitive seizures, and neonatal seizures (Level U).
References
- ↑ Gavvala JR, Schuele SU (2016). "New-Onset Seizure in Adults and Adolescents: A Review". JAMA. 316 (24): 2657–2668. doi:10.1001/jama.2016.18625. PMID 28027373.
- ↑ Ahmad S, Beckett MW (2004). "Value of serum prolactin in the management of syncope". Emerg Med J. 21 (2): e3. doi:10.1136/emj.2003.008870. PMC 1726305. PMID 14988379.
- ↑ Chen DK, So YT, Fisher RS, Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology (2005). "Use of serum prolactin in diagnosing epileptic seizures: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology". Neurology. 65 (5): 668–75. doi:10.1212/01.wnl.0000178391.96957.d0. PMID 16157897.