血清催乳素测定在复杂部分性发作鉴别诊断中的临床价值

The clinical value of serum prolactin measurement in the differential diagnosis of complex partial seizures.

作者信息

Wroe S J, Henley R, John R, Richens A

机构信息

Epilepsy Unit, University of Wales College of Medicine, Cardiff U.K.

出版信息

Epilepsy Res. 1989 May-Jun;3(3):248-52. doi: 10.1016/0920-1211(89)90031-4.

DOI:10.1016/0920-1211(89)90031-4

PMID:2499452

Abstract

The time course of changes in serum prolactin after complex partial seizures has been determined and compared to similar changes after other types of seizure and non-epileptic attacks. Seizures in 33 subjects were recorded on video EEG telemetry. Peak serum prolactin concentrations occurred 15-20 min after tonic-clonic seizures, 10 min after complex partial seizures, and were highest after generalised tonic-clonic seizures. Serum prolactin concentrations remained less than 1000 mU/l after absences and non-epileptic attacks. Application of Bayes' theorem showed that where serum prolactin was greater than 1000 mU/l 5-10 min post event this would identify genuine tonic-clonic or complex partial seizures. The false negative rate of this test was 9% for tonic-clonic seizures and 38% for complex partial seizures. Failure of serum prolactin to rise after an attack is of little value in distinguishing complex partial seizures from non-epileptic attacks.

摘要

已确定复杂部分性发作后血清催乳素变化的时间过程，并与其他类型发作及非癫痫性发作后的类似变化进行了比较。通过视频脑电图遥测记录了33名受试者的发作情况。强直阵挛性发作后15 - 20分钟血清催乳素浓度达到峰值，复杂部分性发作后10分钟达到峰值，全身性强直阵挛性发作后血清催乳素浓度最高。失神发作和非癫痫性发作后血清催乳素浓度保持在1000 mU/l以下。应用贝叶斯定理表明，事件发生后5 - 10分钟血清催乳素大于1000 mU/l时，可识别真正的强直阵挛性发作或复杂部分性发作。该检测对强直阵挛性发作的假阴性率为9%，对复杂部分性发作的假阴性率为38%。发作后血清催乳素未升高对区分复杂部分性发作和非癫痫性发作价值不大。