Seizure laboratory findings

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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:

• Hypoglycemia
• Hyponatremia
• Uremia
• Drug intoxication
• Ammonia levels
• Creatine kinase (CK) levels
• Lactate levels
• Prolactin levels

Serum Prolactin Level

• A study found that:
  • 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.
• Another study found that:
  • 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).