Chronic encephalopathy work-up
Serum glucose, electrolytes, calcium/phosphorus,
renal and thyroid
function tests ,
,CPK, LDH, blood gasses and anion gap, ammonium, lactate.
Drug screening: benzodiazepines, opiates, barbiturates, ethanol, theophylline, anti-epileptic drugs, tricyclic antidepressants.
Toxic screen: 24 hour urine for heavy metals
Serum cortisol, PTH and osmolality.
ANA, ENA, anti-ds-DNA, ANCA, RF, complement, ACE, anti-thyroglobulin and anti-thyroperoxidase antibodies (Hashimoto disease), autoantibody panel (antimicrosomal, antiparietal), immunoglobulins Ig(G, A, M, kappa and lambda),
ceruloplasmin and copper, 24h urinary copper, slit lamp, liver biopsy (WD)
Serum vitamin B12 and folic acid
Serology: HIV, hepatitis (A,B,C), RPR,
TPHA , Lyme,
Ketones and Bence-Jones protein urine. Urinary organic acids.
EEG (non-convulsive status epilepticus)
Brain MRI, MRA, SPECT, (cerebral angiogram)
Besides routine analysis (chemistry, cell count, smear and stainings): lactate and pyruvate (mitochondrial disease), oligoclonal bands, IgG index, VDRL, viral (measles titer, western and eastern equine virus), bacterial (B. burgerdorfi), fungal (Cryptococcus), PCR (T. Whippleii, JC virus, HSV, VZV, CMV), Ziehl staining, repeated cytology,
anti-thyroglobulin and anti-thyroperoxidase antibodies (Hashimoto disease).
14-3-3 protein (CJD) (stable at room temperature and can be sent by regular mail)
Anti-Hu, anti-Yo antibodies, VGKC, antiphospholipid and antineuronal nuclear antibodies I and II, calcium channel antibodies, ampiphysin (paraneoplastic syndromes)
Methylmalonic acid, VLCFA, arylsulphatase, homocysteine. Plasma quantitative amino acids and carnitine and acylcarnitines.
Small bowel (Whipple disease)
Skin (SLE, vasculitis, CADASIL)
CAG repeat (HD)
Back to Top