Movement Disorder, Autoimmune Evaluation, Spinal Fluid - Mayo Clinic Laboratories Rochester

Specimen Required

Container/Tube: Sterile vial

Specimen Volume: 4 mL

Forms

If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.

Useful For

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

Profile Information

Test ID	Reporting Name	Available Separately	Always Performed
MDCI	Movement Disorder Interp, CSF	No	Yes
AMPHC	Amphiphysin Ab, CSF	No	Yes
AGN1C	Anti-Glial Nuclear Ab, Type 1	No	Yes
ANN1C	Anti-Neuronal Nuclear Ab, Type 1	No	Yes
ANN2C	Anti-Neuronal Nuclear Ab, Type 2	No	Yes
ANN3C	Anti-Neuronal Nuclear Ab, Type 3	No	Yes
CS2CC	CASPR2-IgG CBA, CSF	No	Yes
CRMWC	CRMP-5-IgG Western Blot, CSF	Yes	Yes
CRMC	CRMP-5-IgG, CSF	No	Yes
DPPIC	DPPX Ab IFA, CSF	No	Yes
GD65C	GAD65 Ab Assay, CSF	Yes	Yes
LG1CC	LGI1-IgG CBA, CSF	No	Yes
GL1IC	mGluR1 Ab IFA, CSF	No	Yes
NMDCC	NMDA-R Ab CBA, CSF	No	Yes
PCTRC	Purkinje Cell Cytoplasmc Ab Type Tr	No	Yes
PCA1C	Purkinje Cell Cytoplasmic Ab Type 1	No	Yes
PCA2C	Purkinje Cell Cytoplasmic Ab Type 2	No	Yes

Reflex Tests

Test ID	Reporting Name	Available Separately	Always Performed
ABLTC	Amphiphysin Western Blot, CSF	No	No
AMPIC	AMPA-R Ab IF Titer Assay, CSF	No	No
AMPCC	AMPA-R Ab CBA, CSF	No	No
DPPTC	DPPX Ab IFA Titer, CSF	No	No
DPPCC	DPPX Ab CBA, CSF	No	No
GABIC	GABA-B-R Ab IF Titer Assay, CSF	No	No
GABCC	GABA-B-R Ab CBA, CSF	No	No
GL1TC	mGluR1 Ab IFA Titer, CSF	No	No
GL1CC	mGluR1 Ab CBA, CSF	No	No
NMDIC	NMDA-R Ab IF Titer Assay, CSF	No	No
WBNC	Paraneoplas Autoantibody WBlot,CSF	No	No

Testing Algorithm

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 cell-binding assay (CBA) and AMPA-R titer are performed at an additional charge.

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

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

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

If IFA pattern suggests NMDA-R antibody and NMDA-R CBA is positive, then NMDA-R titer 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 Autoimmune Evaluation Algorithm-Spinal Fluid in Special Instructions.

Method Name

ANN1C, ANN2C, ANN3C, PCA1C, PCA2C, PCTRC, AMPHC, CRMC, AGN1C, DPPIC, DPPTC, GL1IC, GL1TC, AMPIC, GABIC, NMDIC: Indirect Immunofluorescence Assay (IFA)

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

ABLTC, CRMWC, WBNC: Western Blot (WB)

GD65C: Radioimmunoassay (RIA)

Reporting Name

Movement Autoimmune Eval, CSF

Specimen Type

CSF

Specimen Minimum Volume

3.5 mL

Specimen Stability Information

Specimen Type	Temperature	Time
CSF	Refrigerated (preferred)	28 days
	Frozen	28 days
	Ambient	72 hours

Reference Values

Test ID	Reporting Name	Methodology	Reference Value
AMPHC	Amphiphysin Ab, CSF	Immunofluorescence assay (IFA)	<1:2
AGN1C	Anti-Glial Nuclear Ab, Type 1	IFA	<1:2
ANN1C	Anti-Neuronal Nuclear Ab, Type 1	IFA	<1:2
ANN2C	Anti-Neuronal Nuclear Ab, Type 2	IFA	<1:2
ANN3C	Anti-Neuronal Nuclear Ab, Type 3	IFA	<1:2
CS2CC	CASPR2-IgG CBA, CSF	Cell-binding assay (CBA)	Negative
CRMWC	CRMP-5-IgG Western Blot, CSF	Western blot (WB)	Negative
CRMC	CRMP-5-IgG, CSF	IFA	<1:2
DPPIC	DPPX Ab IFA, CSF	IFA	Negative
GD65C	GAD65 Ab Assay, CSF	Radioimmunoassay (RIA)	≤0.02 nmol/L
LG1CC	LGI1-IgG CBA, CSF	CBA	Negative
GL1IC	mGluR1 Ab IFA, CSF	IFA	Negative
NMDCC	NMDA-R Ab CBA, CSF	CBA	Negative
PCTRC	Purkinje Cell Cytoplasmic Ab Type Tr	IFA	<1:2
PCA1C	Purkinje Cell Cytoplasmic Ab Type 1	IFA	<1:2
PCA2C	Purkinje Cell Cytoplasmic Ab Type 2	IFA	<1:2

Reflex Information:

Test ID	Reporting Name	Methodology	Reference Value
ABLTC	Amphiphysin Western Blot, CSF	WB	Negative
AMPIC	AMPA-R Ab IF Titer Assay, CSF	IFA	<1:2
AMPCC	AMPA-R Ab CBA, CSF	CBA	Negative
DPPTC	DPPX Ab IFA Titer, CSF	IFA	<1:2
DPPCC	DPPX Ab CBA, CSF	CBA	Negative
GABIC	GABA-B-R Ab IF Titer Assay, CSF	IFA	<1:2
GABCC	GABA-B-R Ab CBA, CSF	CBA	Negative
GL1TC	mGluR1 Ab IFA Titer, CSF	IFA	<1:2
GL1CC	mGluR1 Ab CBA, CSF	CBA	Negative
NMDIC	NMDA-R Ab IF Titer Assay, CSF	IFA	<1:2
WBNC	Paraneoplastic Autoantibody WBlot, CSF	WB	Negative

Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, ANNA-2, CRMP-5-IgG, PCA-1, PCA-2, or PCA-Tr may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."

Day(s) and Time(s) Performed

AMPHC, AGN1C, ANN1C, ANN2C, ANN3C, CRMC, DPPIC, GL1IC, PCA1C, PCA2C, PCTRC, AMPIC, DPPTC, GABIC, GL1TC, NMDIC:

Monday through Friday; 5 a.m., 7 a.m., 5 p.m.

Saturday, Sunday; 6 a.m.

CRMWC, ABLTC, WBNC:

Monday, Wednesday, Friday; 8 a.m.

GD65C:

Monday through Friday; 5 a.m., 2 p.m.

Saturday, Sunday; 7 a.m.

CS2CC, LG1CC, AMPCC, GABCC, NMDCC:

Monday through Thursday; 10 p.m.

Sunday; 3 p.m.

DPPCC, GL1CC:

Wednesday; 6 p.m.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

86255 x14

84182 x1

86341 x1

86255 x4 (if appropriate)

86256 x5 (if appropriate)

84182 x2 (if appropriate)

LOINC Code Information

Test ID	Test Order Name	Order LOINC Value
MDC2	Movement Autoimmune Eval, CSF	In Process

Result ID	Test Result Name	Result LOINC Value
61513	NMDA-R Ab CBA, CSF	In Process
64280	LGI1-IgG CBA, CSF	In Process
64282	CASPR2-IgG CBA, CSF	In Process
64929	DPPX Ab IFA, CSF	82989-5
64927	mGluR1 Ab IFA, CSF	In Process
601997	Movement Disorder Interp, CSF	69048-7
89079	AGNA-1, CSF	53714-2
5906	Amphiphysin Ab, CSF	56531-7
3852	ANNA-1, CSF	24400-4
7472	ANNA-2, CSF	24401-2
21633	ANNA-3, CSF	90837-6
21650	CRMP-5-IgG, CSF	35385-4
3988	PCA-1, CSF	53713-4
21632	PCA-2, CSF	35143-7
21631	PCA-Tr, CSF	56551-5
21747	CRMP-5-IgG Western Blot, CSF	53707-6
21702	GAD65 Ab Assay, CSF	53708-4
36429	Reflex Added	77202-0

Special Instructions

Movement Disorder Autoimmune Evaluation Algorithm-Spinal Fluid

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

Mayo Clinic Laboratories Rochester

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Test ID MDC2 Movement Disorder, Autoimmune Evaluation, Spinal Fluid