Epilepsy Antibody Evaluation with Reflex to Titer and Line Blot, CSF

Epilepsy Antibody Evaluation with Reflex to Titer and Line Blot, CSF

Test Code

94959
86255 (x19), 86341, 86052, 83519
94959
86255 (x19), 86341, 86052, 83519
Not offered in Quest Diagnostics Nichols Institute (IFD) – San Juan Capistrano. Please provide SERVICE AREA INFORMATION to find available tests you can order.
In-home collection is not available in your area through Quest Mobile.

Clinical Significance

Epilepsy Antibody Evaluation with Reflex to Titer and Line Blot, CSF - Seizure disorder may be the initial presentation of encephalitis due to anti-neural autoantibodies, especially during the acute phase and in younger patients. In addition to screening for a variety of anti-neural autoantibodies using tissue immunofluorescence, this CSF panel includes testing for autoantibodies frequently associated with seizures such as GABA-B receptor, LGI1 and NMDA receptor using cell-based assays. Testing using both CSF and serum increases sensitivity for detection

Test Details

Includes

  • Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF
    Aquaporin-4 (AQP4) Antibody, CBA with Reflex, CSF
    Neurology Antibody, CBA with Reflexes, CSF
    DPPX Receptor Antibody, CBA with Reflex, CSF
    Voltage-Gated Potassium Channel (VGKC) Antibody, CSF

    If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with one or more antibodies including AGNA1 (SOX1), Amphiphysin, ANNA1 (Hu), ANNA2 (Ri), CRMP5(CV2), GAD65, Ma2/Ta, PCA1 (Yo), PCA Tr (DNER), and Zic4, then a line blot consisting of these 10 antibodies will be performed.

    If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with ANNA3, then titer will be performed.

    If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with PCA2, then titer will be performed.

    If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with PCA Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) negative and PCA1 (Yo) negative, then PCA Tr (DNER) Ab, CBA, CSF will be performed at an additional charge (CPT code(s): 86255).
    If PCA Tr (DNER) Ab, CBA, CSF is positive, then titer will be performed.

    If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with Myelin Antibody, then titer will be performed at an additional charge (CPT code(s): 86256).

    If the Aquaporin 4 (AQP4) Antibody, CBA is positive, then titer will be performed at an additional charge (CPT code(s): 86052).

    If the Neurology Antibody, CBA is positive for NMDAR1, AMPAR2, LGI1, or CASPR2, then titers will be performed at an additional charge (CPT code(s): 86256 for each titer performed).
    If the Neurology Antibody, CBA is positive for AMPAR1 or GABABR, then titers will be performed.

    If the DPPX Antibody, CBA is positive, then titer will be performed.

Reference Range(s)

See Laboratory Report

Alternative Name(s)

Epilepsy-Autoimmune Eval, CSF,Epilepsy panel,Autoimmune Epilepsy Panel w/Rfl,CSF,Neuroimmunology

LOINC® Codes, Performing Laboratory

Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF
Aquaporin-4 (AQP4) Antibody, CBA with Reflex, CSF
Neurology Antibody, CBA with Reflexes, CSF
DPPX Receptor Antibody, CBA with Reflex, CSF
Voltage-Gated Potassium Channel (VGKC) Antibody, CSF

If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with one or more antibodies including AGNA1 (SOX1), Amphiphysin, ANNA1 (Hu), ANNA2 (Ri), CRMP5(CV2), GAD65, Ma2/Ta, PCA1 (Yo), PCA Tr (DNER), and Zic4, then a line blot consisting of these 10 antibodies will be performed.

If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with ANNA3, then titer will be performed.

If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with PCA2, then titer will be performed.

If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with PCA Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) negative and PCA1 (Yo) negative, then PCA Tr (DNER) Ab, CBA, CSF will be performed at an additional charge (CPT code(s): 86255).
If PCA Tr (DNER) Ab, CBA, CSF is positive, then titer will be performed.

If the Epilepsy Antibody Screen, Tissue, IFA with Reflexes, CSF suggests a fluorescence pattern consistent with Myelin Antibody, then titer will be performed at an additional charge (CPT code(s): 86256).

If the Aquaporin 4 (AQP4) Antibody, CBA is positive, then titer will be performed at an additional charge (CPT code(s): 86052).

If the Neurology Antibody, CBA is positive for NMDAR1, AMPAR2, LGI1, or CASPR2, then titers will be performed at an additional charge (CPT code(s): 86256 for each titer performed).
If the Neurology Antibody, CBA is positive for AMPAR1 or GABABR, then titers will be performed.

If the DPPX Antibody, CBA is positive, then titer will be performed.

Reference Range(s)

See Laboratory Report

Alternative Name(s)

Epilepsy-Autoimmune Eval, CSF,Epilepsy panel,Autoimmune Epilepsy Panel w/Rfl,CSF,Neuroimmunology

Preferred Specimen(s)

4 mL CSF collected in a sterile leak-proof container

Minimum Volume

2 mL

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

  • Room temperature: 24 hours
  • Refrigerated: 7 days
  • Frozen: 21 days

Reject Criteria

Received room temperature

Setup Schedule

4 mL CSF collected in a sterile leak-proof container
2 mL
Refrigerated (cold packs)
Room temperature: 24 hours
Refrigerated: 7 days
Frozen: 21 days
Received room temperature
Not offered in Quest Diagnostics Nichols Institute (IFD) – San Juan Capistrano. Please provide SERVICE AREA INFORMATION to find available tests you can order.
In-home collection is not available in your area through Quest Mobile.
Test Details

Clinical Significance

Test Resources

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided are based on AMA guidance and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

This material contains content from LOINC® (http://loinc.org). The LOINC Table, LOINC Table Core are copyright © 1995-2019, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license.

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