Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which hormone is primarily used to differentiate between a true seizure and a pseudoseizure?

Cortisol
Prolactin
Testosterone
Serotonin

The correct answer is: Prolactin

Prolactin is the hormone that is primarily used to differentiate between a true seizure and a pseudoseizure. After a generalized tonic-clonic seizure, prolactin levels typically increase significantly. This is because the stress and metabolic changes during a seizure stimulate the secretion of prolactin from the pituitary gland. In contrast, in persons experiencing pseudoseizures, which are often psychological in origin, the prolactin levels do not exhibit the same elevated response. This diagnostic marker is particularly useful in clinical settings, as it helps healthcare providers distinguish between non-epileptic events and true seizures, allowing for more appropriate treatment interventions. The other hormones listed do not serve a comparable role in making this critical distinction; for example, cortisol might be influenced by various stress responses but does not specifically indicate seizure activity. Thus, the elevation of prolactin following an episode is a reliable biomarker for confirming the occurrence of a true seizure.