Test Catalog

Test ID: MDC1    
Movement Disorder Evaluation, Spinal Fluid

Useful For Suggests clinical disorders or settings where the test may be helpful

Evaluating patients with suspected paraneoplastic or other autoimmune movement disorders including patients with ataxia, chorea, dyskinesias, myoclonus, parkinsonism, and stiff-person spectrum.

Highlights

Autoimmune movement disorders encapsulate a large and diverse group of neurologic disorders occurring either in isolation or accompanying more diffuse autoimmune encephalitic illnesses.

 

The full range of movement phenomena has been described and, as they often occur in adults, many of the presentations can mimic neurodegenerative disorders, such as Huntington disease. Disorders may be ataxic, hypokinetic (parkinsonism), or hyperkinetic (myoclonus, chorea, and other dyskinetic disorders).

 

The autoantibody targets are diverse and include neuronal surface proteins such as leucine-rich, glioma-inactivated 1 (LGI1), as well as antibodies reactive with intracellular antigens (such as PCA-1) that are markers of a central nervous system process mediated by CD8+ cytotoxic T cells.

 

In some instances (such as Purkinje cell cytoplasmic antibody-1 (PCA-1) autoimmunity), antibodies detected in serum and cerebrospinal fluid can be indicative of a paraneoplastic cause, and may direct the cancer search. In other instances (such as 65 kDa isoform of glutamic acid decarboxylase (GAD65) autoimmunity), a paraneoplastic cause is very unlikely, and early treatment with immunotherapy may promote improvement or recovery.

Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test IDReporting NameAvailable SeparatelyAlways Performed
MDCIMovement Disorder Interp, CSFNoYes
AMPHCAmphiphysin Ab, CSFNoYes
AGN1CAnti-Glial Nuclear Ab, Type 1NoYes
ANN1CAnti-Neuronal Nuclear Ab, Type 1NoYes
ANN2CAnti-Neuronal Nuclear Ab, Type 2NoYes
ANN3CAnti-Neuronal Nuclear Ab, Type 3NoYes
CS2CCCASPR2-IgG CBA, CSFNoYes
CRMWCCRMP-5-IgG Western Blot, CSFYesYes
CRMCCRMP-5-IgG, CSFNoYes
DPPICDPPX Ab IFA, CSFNoYes
GD65CGAD65 Ab Assay, CSFYesYes
LG1CCLGI1-IgG CBA, CSFNoYes
GL1ICmGluR1 Ab IFA, CSFNoYes
NMDCCNMDA-R Ab CBA, CSFNoYes
PCTRCPurkinje Cell Cytoplasmc Ab Type TrNoYes
PCA1CPurkinje Cell Cytoplasmic Ab Type 1NoYes
PCA2CPurkinje Cell Cytoplasmic Ab Type 2NoYes
VGKCCVGKC-complex Ab IPA, CSFNoYes

Reflex Tests Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test IDReporting NameAvailable SeparatelyAlways Performed
ABLTCAmphiphysin Western Blot, CSFNoNo
AMPICAMPA-R Ab IF Titer Assay, CSFNoNo
AMPCCAMPA-R Ab CBA, CSFNoNo
DPPTCDPPX Ab IFA Titer, CSFNoNo
DPPCCDPPX Ab CBA, CSFNoNo
GABICGABA-B-R Ab IF Titer Assay, CSFNoNo
GABCCGABA-B-R Ab CBA, CSFNoNo
GL1TCmGluR1 Ab IFA Titer, CSFNoNo
GL1CCmGluR1 Ab CBA, CSFNoNo
NMDICNMDA-R Ab IF Titer Assay, CSFNoNo
NMOFCNMO/AQP4 FACS, CSFNoNo
NMOTCNMO/AQP4 FACS Titer, CSFNoNo
WBNCParaneoplas Autoantibody WBlot,CSFNoNo

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If IFA suggests Amphiphysin antibody, then Amphiphysin Western blot are performed at an additional charge.

 

If IFA pattern suggest AMPA-R antibody, then AMPA-R Ab CBA and AMPA-R titer are performed at an additional charge.

 

If IFA pattern suggests DPPX antibody, then DPPX Ab CBA and DPPX titer are performed at an additional charge.

 

If IFA pattern suggests GABA-B-R antibody, then GABA-B-R Ab CBA and GABA-B-R titer are performed at an additional charge.

 

If IFA pattern suggests mGluR1 antibody, then mGluR1 Ab CBA and mGluR1 titer are performed at an additional charge.

 

If IFA pattern suggests NMDA-R antibody and NMDA-R Ab CBA is positive, then NMDA-R titer is performed at an additional charge.

 

If IFA pattern suggests NMO/AQP4-IgG, then NMO/AQP4-IgG FACS is performed at an additional charge.

 

If NMO/AQP4-IgG FACS screen assay requires further investigation, then NMO/AQP4-IgG FACS titration assay is performed at an additional charge.

 

If indirect immunofluorescence assay (IFA) suggests ANN1C, ANN2C, ANN3C, PCA1C, PCA2C, PCTRC or AGN1C, then paraneoplastic autoantibody Western blot is performed at an additional charge.

 

See Movement Disorder Evaluation Algorithm, Spinal Fluid in Special Instructions.

Special Instructions Library of PDFs including pertinent information and forms related to the test

Method Name A short description of the method used to perform the test

ANN1C, ANN2C, ANN3C, PCA1C, PCA2C, PCTRC, AMPHC, CRMC, AGN1C, DPPIC, DPPTC, GL1IC, GLITC, AMPIC, GABIC, NMDIC: Indirect Immunofluorescence Assay (IFA)

 

AMPCC, GABCC, NMDCC, LG1CC, CS2CC, DPPCC, GL1CC: Cell Binding Assay (CBA)

 

NMOFC, NMOTC: Flow Cytometry (FACS)

 

ABLTC, CRMWC, WBNC: Western Blot

 

VGKCC: Radioimmunoassay (RIA)

 

GD65C: Immunoprecipitation Assay

NY State Available Indicates the status of NY State approval and if the test is orderable for NY State clients.

No

Reporting Name Lists a shorter or abbreviated version of the Published Name for a test

Movement Disorder Evaluation, CSF

Aliases Lists additional common names for a test, as an aid in searching

Ataxia
Chorea
Stiff-person
Stiff-man
Myoclonus
Parkinsonism
Dyskinesias
PERM