Ordering Recommendation

Use to evaluate new acute- to subacute-onset epilepsy and incomplete seizure control of <2 years. If new-onset movement disorder is the prominent feature, refer to Autoimmune Movement Disorder Panel, CSF (3006207). If there are subacute-onset neurologic symptoms in the absence of seizures, refer to Autoimmune Encephalopathy/Dementia Panel, CSF (3006202). For testing in individuals <18 years of age, refer to Autoimmune Pediatric CNS Disorders, CSF (3006211).

Testing in both serum and CSF is recommended to maximize diagnostic yield; refer to Autoimmune Epilepsy Panel, Serum (3006204) for serum testing.

Methodology

Semi-Quantitative Cell-Based Indirect Fluorescent Antibody/Semi-Quantitative Indirect Fluorescent Antibody (IFA)/Qualitative Immunoblot/Semi-Quantitative Enzyme-Linked Immunosorbent Assay (ELISA)

Performed

Varies

Reported

3-10 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation
Collect

CSF

Specimen Preparation

Transfer three 1 mL CSF aliquots to ARUP standard transport tubes. (Min: 0.5 mL/aliquot)

Storage/Transport Temperature

Frozen

Unacceptable Conditions

Fluid other than CSF. Grossly hemolyzed specimens.

Remarks
Stability

After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 30 days (avoid repeated freeze/thaw cycles)

Reference Interval

Test Number
Components
Reference Interval
  mGluR1 Ab IgG CBA-IFA Screen, CSF Less than 1:1
  Glutamic Acid Decarboxylase Antibody CSF 0.0-5.0 IU/mL
  LGI1 Ab IgG CBA-IFA Screen, CSF Less than 1:1
  NMDA Receptor Ab IgG CBA-IFA, CSF Less than 1:1
  CASPR2 Ab IgG CBA-IFA Screen, CSF Less than 1:1
  AMPA Receptor Ab IgG CBA-IFA Screen, CSF Less than 1:1
  GABA-BR Ab IgG CBA-IFA Screen, CSF Less than 1:1
  CV2.1 Ab IgG CBA-IFA Screen, CSF Less than 1:1
  DPPX Ab IgG CBA-IFA Screen, CSF Less than 1:1
  SOX1 Antibody, IgG by Immunoblot, CSF Negative
  Amphiphysin Antibody, CSF Negative
  GABA-AR Ab IgG CBA-IFA Screen, CSF Less than 1:1
  Paraneoplastic Abs (PCCA/ANNA) IgG, CSF None Detected

Interpretive Data

Refer to report

Compliance Category

Laboratory Developed Test (LDT)

Note

If NMDA CSF antibody IgG is positive, then titer will be performed. Additional charges apply.
If CV2.1 CSF antibody IgG is positive, then titer will be added. Additional charges apply.
PCCA/ANNA CSF antibody IgG is screened by IFA. If the IFA screen is indeterminate, then a Neuronal Nuclear Antibodies (Hu, Ri, Yo, and Tr/DNER) IgG by Immunoblot will be performed. If the IFA screen is positive at 1:10 or greater, then a PCCA/ANNA antibodies titer and Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot will be performed. Additional charges apply.

If LGI1 CSF antibody IgG is positive, then titer will be added. Additional charges apply.
If CASPR2 CSF antibody IgG is positive, then titer will be added. Additional charges apply.
If AMPA CSF antibody IgG is positive, then titer will be added. Additional charges apply.
If GABA-BR CSF antibody IgG is positive, then titer will be added. Additional charges apply.
If DPPX CSF antibody IgG by IFA is positive, then titer will be added. Additional charges apply.

If GABA-AR CSF antibody IgG by IFA is positive, then titer will be added. Additional charges apply.

If mGluR1 CSF antibody IgG by IFA is positive, then titer will be added. Additional charges apply.

Hotline History

N/A

CPT Codes

86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titer

Components

Component Test Code* Component Chart Name LOINC
2005165 NMDA Receptor Ab IgG CBA-IFA, CSF 80220-7
2010842 Paraneoplastic Abs (PCCA/ANNA) IgG, CSF 14247-1
3001258 AMPA Receptor Ab IgG CBA-IFA Screen, CSF 82732-9
3001268 GABA-BR Ab IgG CBA-IFA Screen, CSF 82984-6
3001987 CASPR2 Ab IgG CBA-IFA Screen, CSF 90820-2
3001991 LGI1 Ab IgG CBA-IFA Screen, CSF 90830-1
3002259 CV2.1 Ab IgG CBA-IFA Screen, CSF 53707-6
3002789 Glutamic Acid Decarboxylase Antibody CSF 42501-7
3002904 SOX1 Antibody, IgG by Immunoblot, CSF 94383-7
3004511 Amphiphysin Antibody, CSF 57750-2
3004513 DPPX Ab IgG CBA-IFA Screen, CSF 94283-9
3006004 GABA-AR Ab IgG CBA-IFA Screen, CSF
3006040 mGluR1 Ab IgG CBA-IFA Screen, CSF 93500-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • AGNA
  • AMPA
  • AMPA-R
  • Amphiphysin
  • ANNA
  • Anti-glial nuclear antibody
  • Anti-neuronal nuclear antibody
  • CASPR2
  • Contactin-associated protein-like-2
  • CRMP-5
  • CV2
  • Dipeptidyl aminopeptidase-like protein 6
  • DPPX
  • Epilepsy
  • GABA-A
  • GABA-AR
  • GABA-B
  • GABA-BR
  • GAD65
  • Glutamic acid decarboxylase
  • Hu
  • IgLON5
  • Leucine-rich glioma inactivated protein-1
  • LGI1
  • metabotropic glutamate receptor 1
  • mGluR1
  • NMDA
  • NMDA-R
  • PCA
  • PCCA
  • Purkinje cell cytoplasmic antibody
  • Ri
  • seizures
  • spells
Autoimmune Epilepsy Panel, CSF