Neurology Lab Panels


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Fatigue Panel

 
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)
 

Neuropathy Panel

 
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:
EMG/NCS, muscle/nerve biopsy
Skin Biopsy
Pestronk:
Motor-sensory neuropathy panel
Muscle mitochondrial enzyme analysis
Muscle Glycogen pathway analysis

Myopathy Panel

 
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.
 
Pestrronk
Muscle mitochondrial enzyme analysis (Pestronk)
Muscle Glycogen pathway analysis (Pestronk)
 
 
Myositis panel (Oklahoma)
 

Altered Mental Status

 
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
 
 
 

Cerebrospinal Fluid (CSF) Studies

Basic CSF Panel
Cell Count, Protein, Glucose Tube #1 and #4
Bacterial and Fungal Gram Stain and Culture, AFB Smear
Other: ACE, VDRL
 
Meningitis/Encephalitis Panel
If panel not available consider PCR
HSV, VZV, EBV, CMV
West Nile, listeria, HTLV1, St Louis Encephalitis
 
MS Panel: Multiple Sclerosis (MS) Profile, Serum and Spinal Fluid
 
Encephalopathy, Autoimmune Evaluation, Spinal Fluid
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Other CSF Studies
Creutzfeldt-Jakob disease (CJD): 14-3-3, tau proteins for CJD
Extra - Other CSF orders to be placed
Documented Opening and Closing Pressure
Documented Total CSF Fluid Drained -
Documented Color of CSF drainage and color change if present
Save CSF for future analysis for 30 Days
 
 

Uncommon Causes of Stroke

Hyper-Coaguable Panel

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

Other

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)

Consider adding

Autoimmune Panel
Vasculitis Panel
CSF Panel
Paraneoplastic Panel
Encephalopathy (Serum+/- CSF) Panel

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
 

Autoimmune Panel

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

Paraneoplastic Panel

 
CT Chest, Abdomen and Pelvis w/wo Contrast (Malignancy Protocol)
Neuroaxis imaging w/wo Contrast
 
Serum: Paraneoplastic Evaluation Algorithm
CSF: Paraneoplastic Autoantibody CSF
 
 
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Mayo Clinic Panels

 
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"If anyone saved a life, it would be as if he saved the life of all mankind"
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