Comprehensive antibody panel
Streamlined testing to pinpoint the precise cause
For patients affected by autoimmune peripheral neuropathy, discerning whether the condition is axonal or demyelinating in nature is critical to identifying the most appropriate treatment. Due to the symptom overlap of axonal and demyelinating causes, however, determining the correct etiology can be challenging when electromyography (EMG) testing and nerve conduction studies are not easily accessible.
Comprehensive autoimmune and paraneoplastic autoantibody testing that evaluates for both axonal and demyelinating causes can simplify and expedite diagnosis, enabling faster access to treatments that place patients on the path toward healing.
Comprehensive antibody panel test menu
Comprehensive Antibody Panel
Our comprehensive antibody panel was developed by world-renowned autoimmune neurologists and uses multiple, leading-edge methods to detect dozens of clinically actionable autoantibodies related to autoimmune and paraneoplastic neuropathies with axonal and demyelinating causes.
Including antibodies that target the peripheral nerve, dorsal root ganglia, and nodal and paranodal antigens, this evaluation supports diagnosis across diverse neuropathy phenotypes, including subacute or progressive neuropathies, atypical or asymmetric presentations, autonomic involvement, or suspected immune-mediated or paraneoplastic causes.
Among the antibodies in our panel are CASPR1 and contactin-1 (CNTN1), and the CASPR1/CNTN1 antibody complex. Including this antibody complex allows for expanded detection of antigen-specific autoimmune nodopathies, since individual neurofascin-155 (NF155) and CNTN1 antibodies can appear in mimics of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Not only can this panel distinguish between CIDP and mimics, but it can also identify Guillain-Barré syndrome (GBS), vasculitis, and many other nodopathies.
- CASPR1 antibodies are often associated with a rapidly progressive sensorimotor neuropathy that presents as prominent neuropathic pain, distal weakness, and sensory symptoms.
- CASPR1/contactin-1 complex antibodies are associated with prominent sensory ataxia that may have acute or subacute onset, asymmetric distribution, and occasionally resemble GBS.
- NF155 antibodies are associated with aclassically younger onset, distal weakness, and marked sensory ataxia and tremor.
- CNTN1 antibodies are often associated with an older onset with severe sensorimotor involvement and sensory ataxia. An associated membranous nephropathy or proteinuria can provide additional evidence of these antibodies.
In cases of antibody positivity, reflex testing is performed to confirm and further characterize the antibody, which enhances the diagnostic sensitivity of the assay.
Key testing
- CNES | Peripheral Nervous System Comprehensive Neuropathy, Autoimmune Evaluation, Serum
- Supports diagnosis of patients with suspected immune-mediated peripheral neuropathy.
- Includes a carefully curated panel of clinically actionable autoantibodies associated with axonal and demyelinating causes of peripheral neuropathy (e.g., CASPR1, CNTN1, NF155).
- Automatically reflexes to confirmatory testing when positive.
- Enables informed treatment decisions.
References
- Shelly S, Klein CJ, Dyck PJB, et al. Neurofascin-155 immunoglobulin subtypes: clinicopathologic associations and neurologic outcomes. Neurology. 2021 Dec 14;97(24):e2392-e2403. doi:10.1212/WNL.0000000000012932. Epub 2021 Oct 11. PMID: 34635556; PMCID: PMC8673722.
- Dubey D, Honorat JA, Shelly S, et al. Contactin-1 autoimmunity: Serologic, neurologic, and pathologic correlates. Neurol Neuroimmunol Neuroinflamm. 2020 May 27;7(4):e771. doi:10.1212/NXI.0000000000000771. PMID: 32461352; PMCID: PMC7286654.
- Dubey D, Lennon VA, Gadoth A, et al. Autoimmune CRMP5 neuropathy phenotype and outcome defined from 105 cases. Neurology. 2018 Jan 9;90(2):e103-e110. doi:10.1212/WNL.0000000000004803. Epub 2017 Dec 8. PMID: 29222126.
- Dubey D. Autoimmune neuromuscular dsorders associated with neural antibodies. Continuum (Minneap Minn). 2024 Aug 1;30(4):1136-1159. doi:10.1212/CON.0000000000001461. PMID: 39088291.
- Sista SR, Crum B, Aboseif A, at al. Motor-neuron-disease-like phenotype associated with IgLON5 disease. J Neurol. 2022 Nov;269(11):6139-6144. doi:10.1007/s00415-022-11262-0. Epub 2022 Jul 20. PMID: 35857139; PMCID: PMC9578379.