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Epilepsy Antibody Evaluation with Reflex to Titer and Line Blot, CSF
Test Code94959
Alias/See Also
1230002396 | LAB2396: Epilepsy Ab Eval w/Rflx Titer and LB, CSF | QUEST EAP: 94959
CPT Codes
86255 (x19), 86341, 86052, 83519
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.
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.
Preferred Specimen
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
Refrigerated: 7 days
Frozen: 21 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Received room temperature
Methodology
See individual assays
FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
Set up: Tues; Report available: 4-13 days
Reference Range
See Laboratory Report
Clinical Significance
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
Performing Laboratory
| Quest Diagnostics Nichols Institute-San Juan Capistrano, CA |
| 33608 Ortega Highway |
| San Juan Capistrano, CA 92675-2042 |
Last Updated: April 21, 2023
