Fisher R S, Chan D W, Bare M, Lesser R P
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Ann Neurol. 1991 Feb;29(2):187-90. doi: 10.1002/ana.410290212.
Measurement of serum prolactin levels can be useful in the diagnosis of epilepsy, since prolactin levels often rise after seizures, but not after most imitators of epilepsy. Utility of the test is limited by the need to obtain blood 10 to 20 minutes after the episode. The present study documents the validity of prolactin measurements using capillary blood, which was obtained by the finger-stick method after a possible seizure and then applied to filter paper. Venous and capillary prolactin levels were determined 10 to 20 minutes after seizure-like episodes in 20 patients who were studied in an epilepsy monitoring unit. Venous and capillary prolactin values correlated, with a Pearson coefficient of 0.90. Using a criteria of any elevation above the laboratory upper limit of normal, capillary prolactin values correctly identified seizure versus pseudoseizure in 9 (100%) of 9 patients with generalized tonic-clonic seizures, in 5 (71%) of 7 patients with complex partial seizures, and 4 (100%) of 4 patients with pseudoseizures. Prolactin values were unaffected by leaving filter paper samples at room temperature for up to 1 week. This study suggests the utility of diagnostic capillary blood collection kits to assist in the diagnosis of epilepsy in outpatients.
测量血清催乳素水平对癫痫的诊断可能有用，因为癫痫发作后催乳素水平常升高，但大多数癫痫模仿发作后则不然。该检测的实用性受到发作后10至20分钟需采集血液这一要求的限制。本研究记录了使用毛细血管血测量催乳素的有效性，毛细血管血是在可能的癫痫发作后通过手指穿刺法采集，然后应用于滤纸。在癫痫监测病房对20例患者进行研究，在类似癫痫发作后10至20分钟测定静脉血和毛细血管血中的催乳素水平。静脉血和毛细血管血中的催乳素值具有相关性，皮尔逊系数为0.90。采用高于实验室正常上限的任何升高作为标准，毛细血管催乳素值在9例全身性强直阵挛发作患者中的9例（100%）、7例复杂部分性发作患者中的5例（71%）以及4例假性发作患者中的4例（100%）中正确识别了癫痫发作与假性发作。催乳素值不受滤纸样本在室温下放置长达1周的影响。本研究表明诊断性毛细血管采血试剂盒有助于门诊患者癫痫的诊断。
