Test ID EPC2 Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
Ordering Guidance
Multiple neuroimmunology profile tests are available. For testing that is performed with each profile, see Autoimmune Neurology Antibody Matrix.
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering provider name, phone number, mailing address, and e-mail address
Specimen Required
Collection 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
Investigating new onset cryptogenic epilepsy with incomplete seizure control and duration of fewer than 2 years using spinal fluid 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 or more pack-years) or other cancer risk factors
-Investigating seizures occurring within the context of a subacute multifocal neurological disorder without an obvious cause, especially in a patient with a past or family history of cancer
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AEPCI | Epilepsy, Interpretation, CSF | No | Yes |
AMPCC | AMPA-R Ab CBA, 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 |
CRMC | CRMP-5-IgG, CSF | No | Yes |
DPPIC | DPPX Ab IFA, CSF | No | Yes |
GABCC | GABA-B-R Ab CBA, CSF | No | Yes |
GD65C | GAD65 Ab Assay, CSF | Yes | Yes |
GFAIC | GFAP IFA, CSF | No | Yes |
LG1CC | LGI1-IgG CBA, CSF | No | Yes |
GL1IC | mGluR1 Ab IFA, CSF | No | Yes |
NCDIC | Neurochondrin IFA, CSF | No | Yes |
NMDCC | NMDA-R Ab CBA, CSF | No | Yes |
PCTRC | Purkinje Cell Cytoplasmc Ab Type Tr | No | Yes |
PCA2C | Purkinje Cell Cytoplasmic Ab Type 2 | No | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AGNBC | AGNA-1 Immunoblot, CSF | No | No |
AMPIC | AMPA-R Ab IF Titer Assay, CSF | No | No |
AMIBC | Amphiphysin Immunoblot, CSF | No | No |
AN1BC | ANNA-1 Immunoblot, CSF | No | No |
AN2BC | ANNA-2 Immunoblot, CSF | No | No |
CRMWC | CRMP-5-IgG Western Blot, CSF | Yes | No |
DPPCC | DPPX Ab CBA, CSF | No | No |
DPPTC | DPPX Ab IFA Titer, CSF | No | No |
GABIC | GABA-B-R Ab IF Titer Assay, CSF | No | No |
GFACC | GFAP CBA, CSF | No | No |
GFATC | GFAP IFA Titer, CSF | No | No |
GL1CC | mGluR1 Ab CBA, CSF | No | No |
GL1TC | mGluR1 Ab IFA Titer, CSF | No | No |
NMDIC | NMDA-R Ab IF Titer Assay, CSF | No | No |
PCTBC | PCA-Tr Immunoblot, CSF | No | No |
AGNTC | AGNA-1 Titer, CSF | No | No |
AN1TC | ANNA-1 Titer, CSF | No | No |
AN2TC | ANNA-2 Titer, CSF | No | No |
AN3TC | ANNA-3 Titer, CSF | No | No |
APHTC | Amphiphysin Ab Titer, CSF | No | No |
CRMTC | CRMP-5-IgG Titer, CSF | No | No |
NCDCC | Neurochondrin CBA, CSF | No | No |
NCDTC | Neurochondrin IFA Titer, CSF | No | No |
PC2TC | PCA-2 Titer, CSF | No | No |
PCTTC | PCA-Tr Titer, CSF | No | No |
Testing Algorithm
If client requests or if the indirect immunofluorescence assay (IFA) patterns suggest collapsin response-mediator protein-5-IgG (CRMP-5-IgG), then CRMP-5-IgG IFA titer and CRMP-5-IgG Western blot will be performed at an additional charge.
If the IFA patterns suggest amphiphysin antibody, then amphiphysin immunoblot and amphiphysin IFA titer will be performed at an additional charge.
If the IFA pattern suggests antiglial nuclear antibody (AGNA)-1, then AGNA-1 immunoblot and AGNA-1 IFA titer will be performed at an additional charge.
If the IFA pattern suggests antineuronal nuclear antibody type 1 (ANNA-1), then ANNA-1 IFA titer, ANNA-1 immunoblot, and ANNA-2 immunoblot will be performed at an additional charge.
If the IFA pattern suggests ANNA-2 antibody, then ANNA-2 IFA titer, ANNA-2 immunoblot and ANNA-1 immunoblot will be performed at an additional charge.
If the IFA pattern suggests ANNA-3 antibody, then ANNA-3 IFA titer will be performed at an additional charge.
If the IFA pattern suggests Purkinje cytoplasmic antibody type 2 (PCA-2), then PCA-2 IFA titer will be performed at an additional charge.
If the IFA pattern suggests PCA-Tr antibody, then PCA-Tr immunoblot and PCA-Tr IFA titer will be performed at an additional charge.
If alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-receptor antibody cell-binding assay (CBA) is positive, then AMPA-receptor antibody IFA titer assay will be performed at an additional charge.
If gamma-aminobutyric acid B (GABA-B)-receptor antibody is positive, then GABA-B-receptor antibody IFA titer assay will be performed at an additional charge.
If the IFA pattern suggests glial fibrillary acidic protein (GFAP) antibody, then GFAP IFA titer and GFAP CBA will be performed at an additional charge.
If N-methyl-D-aspartate (NMDA) receptor antibody CBA is positive, then NMDA-receptor antibody IFA titer assay will be performed at an additional charge.
If the IFA pattern suggests dipeptidyl-peptidase-like protein-6 (DPPX) antibody, then DPPX antibody CBA and DPPX IFA titer will be performed at an additional charge.
If the IFA pattern suggests metabotropic glutamate receptor 1 (mGluR1) antibody, then mGluR1 antibody CBA and mGluR1 IFA titer will be performed at an additional charge.
If the IFA pattern suggests neurochondrin antibody, then neurochondrin antibody CBA and neurochondrin IFA titer will be performed at an additional charge.
For more information see Autoimmune/Paraneoplastic Epilepsy Evaluation Algorithm-Spinal Fluid.
Method Name
AGN1C, AGNTC, AMPIC, AMPHC, APHTC, ANN1C, AN1TC, ANN2C, AN2TC, ANN3C, AN3TC, CRMTC, CRMC, DPPIC, DPPTC, GABIC, GFAIC, GFATC, GL1IC, GL1TC, NCDIC, NCDTC, NMDIC, PCA2C, PC2TC, PCTRC, PCTTC: Indirect Immunofluorescence Assay (IFA)
AMPCC, CS2CS, DPPCC, GABCC, GFACC, LG1CC, GL1CC, NCDCC, NMDCC: Cell Binding Assay (CBA)
CRMWC: Western Blot (WB)
AGNBC, AMIBC, AN1BC, AN2BC, PCTBC: Immunoblot (IB)
GD65C: Radioimmunoassay (RIA)
Reporting Name
Epilepsy, Autoimm/Paraneo, CSFSpecimen Type
CSFSpecimen Minimum Volume
2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
CSF | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 72 hours |
Reference Values
Test ID |
Reporting Name |
Methodology* |
Reference Value |
AEPCI |
Epilepsy, Interpretation, CSF |
Medical interpretation |
NA |
AMPCC |
AMPA-R Ab CBA, CSF |
CBA |
Negative |
AMPHC |
Amphiphysin Ab, CSF |
IFA |
Negative |
AGN1C |
Anti-Glial Nuclear Ab, Type 1 |
IFA |
Negative |
ANN1C |
Anti-Neuronal Nuclear Ab, Type 1 |
IFA |
Negative |
ANN2C |
Anti-Neuronal Nuclear Ab, Type 2 |
IFA |
Negative |
ANN3C |
Anti-Neuronal Nuclear Ab, Type 3 |
IFA |
Negative |
CS2CC |
CASPR2-IgG CBA, CSF |
CBA |
Negative |
CRMC |
CRMP-5-IgG, CSF |
IFA |
Negative |
DPPIC |
DPPX Ab IFA, CSF |
IFA |
Negative |
GABCC |
GABA-B-R Ab CBA, CSF |
CBA |
Negative |
GD65C |
GAD65 Ab Assay, CSF |
RIA |
≤0.02 nmol/L Reference values apply to all ages. |
GFAIC |
GFAP IFA, CSF |
IFA |
Negative |
LG1CC |
LGI1-IgG CBA, CSF |
CBA |
Negative |
GL1IC |
mGluR1 Ab IFA, CSF |
IFA |
Negative |
NCDIC |
Neurochondrin IFA, CSF |
IFA |
Negative |
NMDCC |
NMDA-R Ab CBA, CSF |
CBA |
Negative |
PCTRC |
Purkinje Cell Cytoplasmic Ab Type Tr |
IFA |
Negative |
PCA2C |
Purkinje Cell Cytoplasmic Ab Type 2 |
IFA |
Negative |
Reflex Information:
Test ID |
Reporting Name |
Methodology* |
Reference Value |
AGNBC |
AGNA-1 Immunoblot, CSF |
IB |
Negative |
AGNTC |
AGNA-1 Titer, CSF |
IFA |
<1:2 |
AMPIC |
AMPA-R Ab IF Titer Assay, CSF |
IFA |
<1:2 |
AMIBC |
Amphiphysin Immunoblot, CSF |
IB |
Negative |
AN1BC |
ANNA-1 Immunoblot, CSF |
IB |
Negative |
AN1TC |
ANNA-1 Titer, CSF |
IFA |
<1:2 |
AN2BC |
ANNA-2 Immunoblot, CSF |
IB |
Negative |
AN2TC |
ANNA-2 Titer, CSF |
IFA |
<1:2 |
AN3TC |
ANNA-3 Titer, CSF |
IFA |
<1:2 |
APHTC |
Amphiphysin Ab Titer, CSF |
IFA |
<1:2 |
CRMTC |
CRMP-5-IgG Titer, CSF |
IFA |
<1:2 |
CRMWC |
CRMP-5-IgG Western Blot, CSF |
WB |
Negative |
DPPCC |
DPPX Ab CBA, CSF |
CBA |
Negative |
DPPTC |
DPPX Ab IFA Titer, CSF |
IFA |
<1:2 |
GABIC |
GABA-B-R Ab IF Titer Assay, CSF |
IFA |
<1:2 |
GFACC |
GFAP CBA, CSF |
CBA |
Negative |
GFATC |
GFAP IFA Titer, CSF |
IFA |
<1:2 |
GL1CC |
mGluR1 Ab CBA, CSF |
CBA |
Negative |
GL1TC |
mGluR1 Ab IFA Titer, CSF |
IFA |
<1:2 |
NCDCC |
Neurochondrin CBA, CSF |
CBA |
Negative |
NCDTC |
Neurochondrin IFA Titer, CSF |
IFA |
<1:2 |
NMDIC |
NMDA-R Ab IF Titer Assay, CSF |
IFA |
<1:2 |
PC2TC |
PCA-2 Titer, CSF |
IFA |
<1:2 |
PCTBC |
PCA-Tr Immunoblot, CSF |
IB |
Negative |
PCTTC |
PCA-Tr Titer, CSF |
IFA |
<1:2 |
*Methodology abbreviations:
Immunofluorescence assay (IFA)
Cell-binding assay (CBA)
Western blot (WB)
Radioimmunoassay (RIA)
Immunoblot (IB)
Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, ANNA-2, ANNA-3, PCA-2, or PCA-Tr may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."
Note: CRMP-5 titers lower than 1:2 are detectable by recombinant CRMP-5 Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored spinal fluid (held for 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call the Neuroimmunology Laboratory at 800-533-1710 to request CRMP-5 Western blot.
Day(s) Performed
Profile tests: Monday through Sunday; Reflex tests: Varies
Report Available
8 to 12 daysPerforming Laboratory

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 US Food and Drug Administration.CPT Code Information
86255x17
86341 x1
84182-AGNBC (if appropriate)
86256 AGNTC (if appropriate)
86256-AMPIC (if appropriate)
84182-AMIBC (if appropriate)
84182-AN1BC (if appropriate)
86256 AN1TC (if appropriate)
84182-AN2BC (if appropriate)
86256 AN2TC (if appropriate)
86256 AN3TC (if appropriate)
86256 APHTC (if appropriate)
86256 CRMTC (if appropriate)
84182-CRMWC (if appropriate)
86255-DPPCC (if appropriate)
86256-DPPTC (if appropriate)
86256-GABIC (if appropriate)
86255-GFACC (if appropriate)
86256-GFATC (if appropriate)
86255-GL1CC (if appropriate)
86256-GL1TC (if appropriate)
86255 NCDCC (if appropriate)
86256 NCDTC (if appropriate)
86256-NMDIC (if appropriate)
86256 PC2TC (if appropriate)
84182-PCTBC (if appropriate)
86256 PCTTC (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
EPC2 | Epilepsy, Autoimm/Paraneo, CSF | In Process |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
61513 | NMDA-R Ab CBA, CSF | 93502-3 |
61514 | AMPA-R Ab CBA, CSF | 93491-9 |
61515 | GABA-B-R Ab CBA, CSF | 93426-5 |
34258 | Epilepsy, Interpretation, CSF | 69048-7 |
64280 | LGI1-IgG CBA, CSF | 94288-8 |
64282 | CASPR2-IgG CBA, CSF | 94286-2 |
64929 | DPPX Ab IFA, CSF | 82989-5 |
64927 | mGluR1 Ab IFA, CSF | 94361-3 |
605156 | GFAP IFA, CSF | 94360-5 |
615866 | Neurochondrin IFA, CSF | 101451-3 |
89079 | AGNA-1, CSF | 90827-7 |
5906 | Amphiphysin Ab, CSF | 90815-2 |
3852 | ANNA-1, CSF | 44768-0 |
7472 | ANNA-2, CSF | 56959-0 |
21633 | ANNA-3, CSF | 90836-8 |
21650 | CRMP-5-IgG, CSF | 63216-6 |
21632 | PCA-2, CSF | 90843-4 |
21631 | PCA-Tr, CSF | 90845-9 |
21702 | GAD65 Ab Assay, CSF | 94359-7 |
618897 | IFA Notes | 48767-8 |