Neurology Lab Panels

CBC, CMP, TSH, T3, T4, Cortisol, Folate, Vitamins Bl, B2, B6, B12, MMA, Homocysteine, Vitamin D, Serum ferritin, CK, aldolase, Lactate, pyruvate, Carnitine and acyl-carnitine levels, Long-chain fatty acids, Very Long-chain fatty acids, Medium chain fatty acids, short chain fatty acids, urine organic acids, Serum amino acids, CoQl0 level, AChR abs, MuSK abs, VGKC, Striational abs, Skin Biopsy, EMG/NCS with repetitive nerve stimulation, ABG, Carbon monoxide level, EKG, Cardiac Echo

Other studies: Muscle Biopsy, Muscle mitochondrial enzyme analysis (Pestronk), Muscle Glycogen pathway analysis (Pestronk)

CBC, CMP, TSH, T3, T4, Folate, HgbAlc, Vitamins Bl, B2, B6, B12, MMA, Homocysteine, Vitamin D, Serum ferritin, Lactate, pyruvate, Carnitine and acyl-carnitine levels, CoQlO level, ANA, RF, ENA, ESR, CRP, Serum ACE level, Serum copper, serum or whole blood zinc, ANCA, LFT, HIV, Hepatitis panel, RPR, UPEP, SPEP, IFE, Quantitative Immunoglobulins, C04/C08 counts. SS-A and SS-B Antibodies, Cryoglobulins, Myelin Associated Glycoprotein (MAG) Antibody, Ganglioside (GM1, GD1b, and GQ1b) Antibodies.

Procedures:

Pestronk:

CBC, CMP, TSH, T3, T4, Vitamins Bl, B2, B6, B12, MMA, Homocysteine, Vitamin D, Lactate, pyruvate, Long-chain fatty acids, Very Long-chain fatty acids, Medium chain fatty acids, short chain fatty acids, Urine organic acids, serum amino acids, CK, aldolase, Carnitine and acyl-carnitine levels, CoQlO level, Serum ACE level, ANA, RF, ENA, ESR, CRP, ANCA, LFT, HIV, Hepatitis panel, RPR, UPEP, SPEP, IFE, Quantitative Immunoglobulins, C04/C08 counts, EKG, Cardiac Echo, EMG/NCS with repetitive nerve stimulation, muscle biopsy.

Muscle mitochondrial enzyme analysis (Pestronk)

Muscle Glycogen pathway analysis (Pestronk)

CBC, CMP, Urine Drug screen, Blood alcohol level, Serum drug screen, Ammonia, TSH, T3, T4, Vitamins Bl, B2, B6, B12, MMA, Homocysteine, Vitamin D, Lactate, pyruvate, Long-chain fatty acids, Very Long-chain fatty acids, Medium chain fatty acids, short chain fatty acids, urine organic acids, serum amino acids, CK, aldolase, Carnitine and acyl-carnitine levels, CoQ10 level, serum ACE level, ANA, RF, ENA, ESR, CRP, ANCA, LFT, HIV, Hepatitis panel, HSV PCR, RPR, UPEP, SPEP, IFE, Quantitative Immunoglobulins, CD4/CD8 counts, EKG, Cardiac Echo, CSF evaluation. Mycoplasma

*** Urgent/NonUrgent Lumbar Punture

Given the patients age is less than 55 with absence of typical risk factors, Patient is eligible for stoke in young workup to look for uncommon causes of stroke.

Hypercoagulable Panel: Cardiolipin Antibody Panel, Lupus Anticoagulant, Protein S Activity, Protein C Activity, Antithrombin Ill Activity, Methylenetetrahydrofolate reductase (MTHFR), DNA, Activated Protein C Resistance, with Reflex, Hemoglobin Electrophoresis, Sickling Screen w/o Reflex (if indicated), Prothrombin Genotype, Beta 2 Glycoprotein Panel, Factor VIII Assay, Cryoglobulin Qual, Cryofibrinogen

Autoimmune Panel: ANA, RF, ENA, ESR, CRP, ANCA, c-ANCA, p-ANCA, UPEP, SPEP, IFE

Vasculitis Panel: RPR, ANA, RF, ENA, ESR, CRP, Serum ACE level, ANCA, HIV, Hepatitis panel, Myeloperoxidase and Protease 3 AB , Complement Levels (C3 & C4), Lyme Disease by PCR, IFE Serum w/IgG,A,M & Kappa/Lambda Free Light Chain

Cardiolipin AB Panel, Lupus Anticoagulant, Protein S, Protein C Activity, Activated Protein C Resistance Screen Only W/Reflex, Antithrombin III Activity, Homocysteine Total, Fibrinogen Activity, ANA Screen with Reflex IFA, Lipoprotein A, Protein Electrophoresis Serum, Hemoglobin Electrophoresis , Sickling Screen w/o Reflex, Prothrombin Genotype, Sedimentation Rate Westergren, C Reactive Protein, RPR , Complement Levels (C3 & C4), D Dimer Quantitative , Beta-2 Glycoprotein Panel, CRP (C Reactive Protein) High Sensitivity, Factor 8 Assay, Cryoglobulin Qual, Cryofibrinogen

Blood Cultures x 2 (3 days)

Peripheral Smear (Sickle)

Transesophageal Echo

Bil Lower Ext Dopplers

Pelvic MRA (pelvic vein thrombosis)

Digital subtraction Angiogram

CT Chest, Abdomen and Pelvis w/wo Contrast (Malignancy Protocol)

RPR, ANA, RF, ENA, ESR, CRP, Serum ACE level, ANCA, HIV, Hepatitis panel, Myeloperoxidase and Protease 3 AB , Complement Levels (C3 & C4), Lyme Disease by PCR, IFE Serum w/IgG,A,M & Kappa/Lambda Free Light Chain

ANA, RF, ENA, ESR, CRP, ANCA, c-ANCA, p-ANCA, UPEP, SPEP, IFE

CT Chest, Abdomen and Pelvis w/wo Contrast (Malignancy Protocol)

Neuroaxis imaging w/wo Contrast

Serum: Paraneoplastic Evaluation Algorithm

CSF: Paraneoplastic Autoantibody CSF