Epilepsy blood and CSF investigations

Prolactin

• This may help to distinguish seizures from non-epileptic attack disorder (NEAD)
• The sample must be taken 10-20 minutes after the event
• Prolactin however does not distinguish seizures from syncope

Phosphate

Other blood tests

Cerebrospinal fluid (CSF) post-ictal features

References

1. Chen DK, So YT, Fisher RS. Use of serum prolactin in diagnosing epileptic seizures: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2005; 65:668-675.
2. Barras P, Siclari F, Hügli O, Rossetti AO, Lamy O, Novy J. A potential role of hypophosphatemia for diagnosing convulsive seizures: a case-control study. Epilepsia 2019; 60:1580-1585. 
3. Coutinho MP, Faustino P, Ladeira F, Leitão L. Hypophosphatemia as a possible biomarker for epileptic seizures at the emergency department. Seizure 2023; 111:42-44.
4. Pohlmann-Eden B, Beghi E, Camfield C, Camfield P. The first seizure and its management in adults and children. BMJ 2006; 332:339-342.
5. Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2007; 69:1996-2007.
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Related checklists

• Epilepsy electroencephalogram (EEG)