Serum prolactin in neonatal seizures.

BACKGROUND

Prolactin is the most specific neurohormone that is elevated after seizures. This study was undertaken to determine the clinical usefulness of plasma prolactin as a diagnostic aid in differential diagnosis of neonatal convulsions.

METHODS

Forty-five patients followed for seizures were included in the study. Postictal serum prolactin levels were obtained 30 min after the onset of the seizures. A second sample obtained 24 h later was used to measure an unstimulated serum prolactin level.

RESULTS

The most common cause of seizure was hypoxic ischemic encephalopathy (HIE) followed by sepsis. In patients with HIE, postictal serum prolactin levels were significantly higher than the unstimulated levels (P < 0.0002). Additionally, postictal prolactin levels were significantly higher than the unstimulated levels in clonic (P < 0.02) and tonic convulsions (P < 0.001).

CONCLUSIONS

We conclude that the postictal serum prolactin level may be a marker in the differentiation of seizures as well as providing important information about their etiology. Further studies are needed to assess the normal range of serum prolactin levels in unstressed newborns.