Evaluating Serum Prolactin and Creatine Phosphokinase as Differential Biomarkers in Epileptic Versus Psychogenic Non-Epileptic Seizures

Title: Evaluating the role of Prolactin and Creatine-Phosphokinase as biomarkers for differentiating Epileptic seizures from Psychogenic Non-Epileptic seizures – A Prospective Study

Accurately distinguishing Epileptic Seizures from Psychogenic Non-Epileptic Seizures is crucial for proper treatment. Seizures are caused by abnormal neuronal activity in the brain, while epilepsy refers to recurrent seizures due to an underlying chronic condition. In contrast, PNES are non-epileptic, emotionally triggered events that often resemble Epileptic seizures, making diagnosis challenging. PNES can occur in both epileptic and non-epileptic patients and is commonly linked to psychological conditions like somatoform disorders. The gold standard for diagnosing epilepsy is a positive EEG, though a negative EEG does not exclude the diagnosis. In settings where video-EEG is unavailable, there is a pressing need for more accessible diagnostic tools. Misdiagnosis can lead to unnecessary treatment with antiepileptic drugs, which can have significant side effects. Therefore, alternative diagnostic methods are needed. This study explores the potential of serum Prolactin and Creatine Phosphokinase as biomarkers to differentiate between Epileptic Seizures and Psychogenic Non-Epileptic Seizures. Elevated Prolactin levels are often seen in Epileptic Seizures, especially Generalized Tonic-Clonic Seizures. At the same time, Creatine Phosphokinase levels may also be higher in Epileptic Seizures due to muscle injury during convulsions. In this study, inpatients and outpatients with a history of Epileptic Seizures and Psychogenic Non-Epileptic Seizures will be referred for Prolactin and Creatine Phosphokinase testing within 1 hour of seizure onset. The results will be analyzed to determine whether Prolactin and Creatine Phosphokinase levels can reliably differentiate between Epileptic and Non-Epileptic Seizures, particularly in settings with limited access to advanced diagnostic tools like video-EEG. Findings could improve the accuracy of seizure diagnoses and help prevent unnecessary treatments.