Does serum prolactin indicate the presence of seizure in the emergency department patient?
OBJECTIVE
We sought to evaluate whether there was a correlation between elevated serum prolactin in patients presenting with the question of seizure.


METHODS
A Convenience sample of 200 consecutive patients were chosen who had a serum prolactin measurement in the setting of seizure activity.


RESULTS
The prolactin level was within a range of 3.90-294.00 mg/dl with an upper limit of normal being 29.9 mg/dl. Patients were ultimately diagnosed with seizure in 54.5% (109 of 200) with an abnormal prolactine in 31.0% (62 of 200). The sensitivity of this serum prolactin was 42%, the specificity was 82%, positive predictive value (PPV) of 74%, and negative predictive value (NPV) of 54%. There was an overall accuracy of 60% in the diagnosis of seizure, with a likelihood ratio of 2.4 (95% Confidence Interval [CI], 1.5-3.9).


CONCLUSIONS
The measurement of serum prolactin is helpful as a confirmatory test, but not as screening test in the emergency department setting.
Vukmir
Rade B
RB
University of Pittsburgh, Medical Center UPMC, Northwest One Spruce Street, Franklin, PA 16323, USA. RVUKMIR@eci-med.com
D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004569:Electroencephalography / Q000379:methods; D004636:Emergency Service, Hospital; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011388:Prolactin / Q000097:blood*; D011446:Prospective Studies; D012189:Retrospective Studies; D012640:Seizures / Q000097:blood / Q000175:diagnosis*; D012680:Sensitivity and Specificity
D015415:Biomarkers; D011388:Prolactin