Test ID: EPS2    
Epilepsy, Autoimmune Evaluation, Serum

Investigating new onset cryptogenic epilepsy with incomplete seizure control and duration of less than 2 years in serum 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

-A rising autoantibody titer in a previously seropositive patient suggests cancer recurrence

If indirect immunofluorescence assay (IFA) (ANN1S, ANN2S, PCAB2) is indeterminate, then paraneoplastic autoantibody Western blot is performed at an additional charge.

If client requests or if IFA patterns suggest collapsin response-mediator protein-5-IgG (CRMP-5-IgG), then CRMP-5-IgG Western blot, acetylcholine receptor muscle binding, and acetylcholine muscle modulating antibody are performed at an additional charge.

If IFA patterns suggest amphiphysin antibody, then amphiphysin Western blot is performed at an additional charge.

If IFA pattern suggests AMPA-receptor antibody, and AMPA-receptor antibody cell-binding assay (CBA) is positive, then AMPA-receptor antibody IF titer assay is performed at an additional charge.

If AMPA-receptor antibody CBA is positive, then CRMP-5-IgG Western blot, ACh receptor (muscle) binding antibody, and ACh receptor (muscle) modulating antibody are performed at an additional charge.

If CASPR2-receptor antibody CBA is positive, then CRMP-5-IgG Western blot, ACh receptor (muscle) binding antibody, and ACh receptor (muscle) modulating antibody are performed at an additional charge.

If IFA pattern suggests GABA-B-receptor antibody, and GABA-B-Receptor antibody is positive, then GABA-B-receptor antibody IF titer assay is performed at an additional charge.

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

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

If IFA patterns suggest PCA-1, then Purkinje cell cytoplasmic antibody type 1 assay is performed at an additional charge.

See Epilepsy Autoimmune Evaluation Algorithm, Serum in Special Instructions.

• Epilepsy Autoimmune Evaluation Algorithm-Serum

ANN1S, ANN2S, ANN3S, PCABP, PCAB2, PCATR, AMPHS, CRMS, AGN1S, DPPIS, DPPTS, GL1IS, GLITS, GFAIS, GFATS, AMPIS, GABIS, NMDIS: Indirect Immunofluorescence Assay (IFA)

AMPCS, GABCS, NMDCS, LG1CS, CS2CS, DPPCS, GL1CS, GFACS: Cell Binding Assay (CBA)

ABLOT, CRMWS, WBN: Western Blot (WB):

CCN, CCPQ, GANG, ARBI, GD65S: Radioimmunoassay (RIA)

ARMO: Live Cell Assay (LCA)