Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid-12689

Serum is the preferred specimen and is more sensitive for all antibodies except for NMDA and GFAP for which CSF is somewhat more sensitive.

Test info

  
Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
  
12689
  
LAB12689
  
ENC1
  
Behavioral change
Confusion
ENCEC
Encephalitis
Glutamic Acid Decarboxylase (GAD65)
Leucine-Rich Glioma Inactivated Protein-1 IgG
Limbic encephalitis
metabotropic glutamate receptor 1
Psychosis
  
  • Encephalopathy, Interpretation, S
  • AMPA-R Ab CBA, S
  • Amphiphysin Ab, S
  • Anti-Glial Nuclear Ab, Type 1
  • Anti-Neuronal Nuclear Ab, Type 1
  • Anti-Neuronal Nuclear Ab, Type 2
  • Anti-Neuronal Nuclear Ab, Type 3
  • CASPR2-IgG CBA, S
  • CRMP-5-IgG, S
  • DPPX Ab IFA, S
  • GABA-B-R Ab CBA, S
  • GAD65 Ab Assay, S
  • GFAP IFA, S
  • IgLON5 IFA, S
  • LGI1-IgG CBA, S
  • mGluR1 Ab IFA, S
  • Neurochondrin IFA, S
  • NIF IFA, S
  • NMDA-R Ab CBA, S
  • Purkinje Cell Cytoplasmic Ab Type 1
  • Purkinje Cell Cytoplasmic Ab Type 2
  • Purkinje Cell Cytoplasmic Ab Type Tr
  • Septin-7 IFA, S
For reflex tests, see algorithm in Clinical and Interpretive info tab
  

 

  • Evaluating new onset encephalopathy (noninfectious or metabolic) comprising confusional states, psychosis, delirium, memory loss, hallucinations, movement disorders, sensory or motor complaints, seizures, dyssomnias, ataxias, nausea, vomiting, inappropriate antidiuresis, coma, dysautonomias, or hypoventilation in spinal fluid specimens

    The following accompaniments should increase of suspicion for autoimmune encephalopathy:
    • Headache
    • Autoimmune stigmata (personal or family history or signs of diabetes mellitus, thyroid disorder, vitiligo, poliosis [premature graying], myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)
    • History of cancer
    • Smoking history (20+ pack years) or other cancer risk factors
    • Inflammatory cerebral spinal fluid (or isolated protein elevation)
    • Neuroimaging signs suggesting inflammation
  • Evaluating limbic encephalitis (noninfectious)
  • Directing a focused search for cancer
  • Investigating encephalopathy appearing in the course or wake of cancer therapy and not explainable by metastasis or drug effect
  

Serum is the preferred specimen and is more sensitive for all antibodies except for NMDA and GFAP for which CSF is somewhat more sensitive.

Specimen

  
Cerebrospinal fluid (CSF)
  

Sterile vial/container

  
4.0 mL
  
2.0 mL
  

Refrigerated (preferred) - 28 days

Frozen - 28 days

Ambient - 72 hrs

  
  • Gross hemolysis
  • Gross lipemia
  • Gross icterus

Performance

  
Mayo Clinic Laboratories (ENC2): R-MM
  
Daily
  
8 - 12 days
  

Immunofluorescence Assay (IFA), Cell Binding Assay (CBA), Western Blot (WB), Radioimmunoassay (RIA) and Immunoblot (IB)

Clinical and Interpretive info

  

See report

Billing

  
86255 x 21
86341

Additional CPT codes (if appropriate):
84182-AGNBS
86256 AGNTS
86255-AINCS
86256-AMPIS
86256 APHTS
84182-AMIBS
84182-AN1BS
86256 AN1TS
84182-AN2BS
86256 AN2TS
86256 AN3TS
86256 CRMTS
84182-CRMWS
86255-DPPCS
86256-DPPTS
86256-GABIS
86255-GFACS
86256-GFATS
86255-IG5CS
86256-IG5TS
86255-GL1CS
86256-GL1TS
86255 NCDCS
86256 NCDTS
86255-NFHCS
86256-NIFTS
86255-NFLCS
86256-NMDIS
84182-PC1BS
86256 PC1TS
86256 PC2TS
84182-PCTBS
86256 PCTTS
86255 SP7CS
86256 SP7TS

Tracking

  
11/18/2014
  
02/01/2024
  
01/02/2024