Seizure laboratory findings

Jump to navigation Jump to search

Seizure Microchapters


Patient Information


Historical Perspective




Differentiating Seizure from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings




Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Seizure laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Seizure laboratory findings

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical

US National Guidelines Clearinghouse

NICE Guidance

FDA on Seizure laboratory findings

CDC on Seizure laboratory findings

Seizure laboratory findings in the news

Blogs on Seizure laboratory findings

Directions to Hospitals Treating Seizure

Risk calculators and risk factors for Seizure laboratory findings

Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory Findings

"Obtaining postictal levels of prolactin (within 20 minutes after a convulsive event), lactate (within 1 to 2 hours), ammonia (within several hours), or creatine kinase (especially 24 to 48 hours postictally) can help differentiate convulsive seizures from psychogenic nonepileptic attacks"[1]


Serum Prolactin Level

Two meta-analyses have quantified the role of an elevated serum prolactin. The first meta-analysis found that:[3] "If a serum prolactin concentration is greater than three times the baseline when taken within one hour of syncope, then in the absence of test "modifiers":

  1. The patient is nine times more likely to have suffered a GTCS as compared with a pseudoseizure positive LR = 8.92 (95% CI (1.31 to 60.91)), SN = 0.62 (95% CI (0.40 to 0.83)), SP = 0.89 (95% CI (0.60 to 0.98))
  2. Five times more likely to have suffered a GTCS as compared with non-convulsive syncope positive LR 4.60 (95% CI (1.25 to 16.90)), SN = 0.71 (95% CI (0.49 to 0.87)), SP = 0.85 (95% CI (0.55 to 0.98)). "

The second meta-analysis found:[4]

  1. "Elevated serum prolactin assay, when measured in the appropriate clinical setting at 10 to 20 minutes after a suspected event, is a useful adjunct for the differentiation of generalized tonic-clonic or complex partial seizure from psychogenic nonepileptic seizure among adults and older children (Level B)."
  2. "Serum prolactin assay does not distinguish epileptic seizures from syncope (Level B).
  3. "The use of serum PRL assay has not been established in the evaluation of status" epilepticus, repetitive seizures, and neonatal seizures (Level U)."

The serum prolactin level is less sensitive for detecting partial seizures.[5]


  1. Wu, Ken; Hirsch, Lawrence J.; Babl, Franz E.; Josephson, S. Andrew (2020). "Choosing Anticonvulsant Medications to Manage Status Epilepticus". New England Journal of Medicine. 382 (26): 2569–2572. doi:10.1056/NEJMclde2004317. ISSN 0028-4793.
  2. Nass RD, Sassen R, Elger CE, Surges R (2017). "The role of postictal laboratory blood analyses in the diagnosis and prognosis of seizures". Seizure. 47: 51–65. doi:10.1016/j.seizure.2017.02.013. PMID 28288363.
  3. Ahmad S, Beckett MW (2004). "Value of serum prolactin in the management of syncope". Emergency medicine journal : EMJ. 21 (2): e3. PMID 14988379.
  4. Chen DK, So YT, Fisher RS (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.
  5. Shukla G, Bhatia M, Vivekanandhan S; et al. (2004). "Serum prolactin levels for differentiation of nonepileptic versus true seizures: limited utility". Epilepsy & behavior : E&B. 5 (4): 517–21. doi:10.1016/j.yebeh.2004.03.004. PMID 15256189.

Template:WH Template:WS