Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

Alphabetical Test listing

Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid-12691

Test name:

Test number:

12691

Excellian order number:

LAB12691

Abbreviation:

EPC2

Alternate names:

Dipeptidyl aminopeptidase-like protein 6
EPIEC
Metabotropic glutamate receptor 1
Seizures
Spells
Leucine-Rich Glioma Inactivated Protein-1 IgG

Tests included:

Epilepsy, Interpretation, CSF
AMPA-R Ab CBA, CSF
Amphiphysin Ab, CSF
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, CSF
CRMP-5-IgG, CSF
DPPX Ab IFA, CSF
GAD65 Ab Assay, CSF
GABA-B-R Ab CBA, CSF
GFAP IFA, CSF
LGI1-IgG CBA, CSF
mGluR1 Ab IFA, CSF
Neurochondrin IFA, CSF
NMDA-R Ab CBA, CSF
Purkinje Cell Cytoplasmc Ab Type Tr
Purkinje Cell Cytoplasmic Ab Type 2

For reflex tests, see algorithm on Clinical and Interpretive info tab

Useful for:

Investigating new onset cryptogenic epilepsy with incomplete seizure control and duration of less than 2 years using spinal fluid specimens
Investigating new onset cryptogenic epilepsy plus 1 or more of the following accompaniments:

Psychiatric accompaniments (psychosis, hallucinations)
Movement disorder (myoclonus, tremor, dyskinesias)
Headache
Cognitive impairment/encephalopathy
Autoimmune stigmata (personal history or family history or signs of diabetes mellitus, thyroid disorder, vitiligo, premature graying of hair, myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus, idiopathic adrenocortical insufficiency) or "multiple sclerosis"
History of cancer
Smoking history (20+ pack years) or other cancer risk factors
Investigating seizures occurring within the context of a subacute multifocal neurological disorder without obvious cause, especially in a patient with past or family history of cancer

Specimen type:

Cerebrospinal fluid (CSF)

Collection container:

Sterile vial/container

Volume:

4.0 mL

Minimum volume:

2.0 mL

Transport container:

Screw-capped polypropylene vial/tube, sterile (Mayo)

Transport and stability:

Refrigerated (preferred) - 28 days

Frozen - 28 days

Ambient - 72 hrs

Specimen retention time:

28 days

Reason for rejection:

Gross hemolysis
Gross lipemia
Gross icterus

Performing lab:

Mayo Clinic Laboratories (EPC2): R-NX

Days set up:

Varies

TAT:

8 - 12 days

Method:

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

Reference ranges:

See report

Clinical information:

Utilization guidelines for neurologic autoimmune panels

Cautions:

Negative results do not exclude autoimmune epilepsy or cancer.

CPT codes:

86255 x 17
86341

Additional CPT codes (if appropriate):
84182-AGNBC
86256 AGNTC
86256-AMPIC
84182-AMIBC
84182-AN1BC
86256 AN1TC
84182-AN2BC
86256 AN2TC
86256 AN3TC
86256 APHTC
86256 CRMTC
84182-CRMWC
86255-DPPCC
86255-DPPCC
86256-GABIC
86255-GFACC
86256-GFATC
86255-GL1CC
86256-GL1TC
86255 NCDCC
86256 NCDTC
86256-NMDIC
86256 PC2TC
84182-PCTBC
86256 PCTTC

Date created:

11/18/2014

Revised date:

02/01/2024

Review date:

02/20/2023