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In article <[log in to unmask]>, Stephen Frost <[log in to unmask]> writes > > >Bill Bartlett wrote: > >> Does anyone have opinion, or hard evidence, as to the utility of prolactin >> measurements in the fit versus pseudo-fit scenario? >> > >Our laboratory provides, amongst other things, a routine service to an >adjacent supra regional neurology centre (HPNC) and I have have been providing >this test for a number of years using finger prick blood spots. I am glad to >share experiences, and would be interested if anyone else has adopted an >similar, or different, approach . > >The main problem with the test is collecting samples at the right time. The >peak rise occurs after 20-30 minutes but by 60 minutes the prolactin has just >about returned to normal, so it is easy to miss it and record a false >negative, for example in casualty. If the patient is admitted, sometimes >there is a long wait for a fit and often EEG is available to help establish a >diagnosis.These are probably the main reasons it isn't used much in the >hospital setting. > ... > >As far as hard evidence goes, before the audit I pulled together a >bibliography of about 50 papers, which show a high degree of agreement, so >there is little doubt that the effect is genuine. It is distinct from >non-specific stress effect which also of course can raise prolactin, as well >as other hormones, but which doesn't cause the typical rapid rise and fall. > ... >So overall, my vote is - not a perfect test but it can help. > You may be interested to know that our consultant endocrinologist has started asking me to perform serial prolactin levels on patients who have had an unexplained high prolactin. (There has been no suspicion of epilepsy in these patients). I insert a venous cannula and take samples at 0, 30, 60, 90 and 120 min. Results so far (from memory) : each patient has had normal prolactin by 60 min. \/ \/ \/ \/ \/ \/ \/ /\____/\____/\____/\____/\____/\____/\____ %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%