Does serum prolactin indicate the presence of seizure in the emergency department patient?

Abstract

Study 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).

Conclusion: The measurement of serum prolactin is helpful as a confirmatory test, but not as screening test in the emergency department setting.