Serum neuron-specific enolase, prolactin, and creatine kinase after epileptic and psychogenic non-epileptic seizures.
OBJECTIVE
To evaluate the discriminative power of serial, simultaneous determinations of serum neuron-specific enolase (NSE), prolactin (PRL) and creatine kinase (CK) in differentiating psychogenic non-epileptic seizures (PNES) from epileptic seizures (ES).


METHODS
Prospective measurement of the three markers after 44 single seizures (32 ES and 12 PNES) during continuous video-EEG monitoring at seven different sampling points.


RESULTS
Patients with ES had a significantly greater increase in PRL at 10, 20, 30 min, 1 and 6 h. The sensitivity for elevated NSE and CK was low. PRL showed a higher sensitivity. However, the corresponding positive predictive value was lower than in CK and NSE. Additionally, PRL had the lowest specificity of all parameters.


CONCLUSIONS
The limited discriminative power of PRL, CK, and NSE calls into question if these markers are helpful in differentiating PNES and ES.
Willert
C
C
Neurological Rehabilitation Center, Greifswald, Germany.
Spitzer
C
C
Kusserow
S
S
Runge
U
U
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood*; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000201:enzymology; D017029:Epilepsy, Complex Partial / Q000175:diagnosis* / Q000201:enzymology; D004830:Epilepsy, Tonic-Clonic / Q000175:diagnosis* / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D011388:Prolactin / Q000097:blood*; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000201:enzymology; D012640:Seizures / Q000175:diagnosis* / Q000201:enzymology; D014741:Video Recording
D015415:Biomarkers; D011388:Prolactin; D003402:Creatine Kinase; D010751:Phosphopyruvate Hydratase