Autoimmune movement disorders

Personalized treatment
for each patient

Autoimmune movement disorders encompass a large and diverse group of neurologic disorders occurring either in isolation or accompanying more diffuse autoimmune encephalitic illnesses. Disorders may be ataxic, hypokinetic (parkinsonism), or hyperkinetic (myoclonus, chorea, and other dyskinetic disorders).

Given the variety of movement phenomena and disorders, treatment protocols should be individualized for each patient and reflect symptom severity, the type of antibody identified, and the presence or absence of cancer. In addition to oncologic therapy (when appropriate), treatment often involves immunotherapy and symptomatic therapy. Often, early initiated immunotherapy gives patients the best possible outcomes.

Expert developed, clinically actionable evaluations

Mayo Clinic Laboratories' comprehensive autoimmune movement disorders panel is continuously updated to include newly discovered antibody biomarkers and uses advanced testing approaches to detect actionable antibodies. Test results can help guide treatment selection, which can involve oncologic therapy (when appropriate) as well as immunotherapy and symptomatic therapy.


Ma2-directed illness

Mayo Clinic Laboratories has optimized detection of Ma2-associated autoimmune encephalitis through development of an innovative, enzyme-linked immunosorbent assay.


Stiff-person spectrum disorders

Learn more about Mayo Clinic Laboratories’ pioneering Stiff Person Spectrum Disorders evaluation, the first commercially available evaluation of its kind to test for all relevant biomarkers for stiff-person spectrum disorders.


By the numbers

9

Novel Antibodies Offered Only At Mayo Clinic Laboratories: KLHL11, GFAP, Septin-5, Septin-7, Neurochondrin, AP3B2, GRAF1, NIF, & GlyR


53%

of autoimmune cerebellar ataxia is paraneoplastic


46%

of autoimmune cerebellar ataxia patients improve with immunotherapy

When to consider testing

Consider autoimmune testing for patients presenting with a movement disorder and one or more of the following:

  • Symptoms of subacute onset (<3 months)
  • Rapid progression, sometimes with fluctuating course
  • Psychiatric accompaniments (psychosis, hallucinations)
  • Headache
  • Autoimmune stigmata (e.g., physical signs or personal/family history of diabetes, thyroid disorder, vitiligo, prematurely gray hair, myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)
  • History of cancer
  • Smoking history (20+ pack years) or other cancer risk factors
  • Inflammatory cerebrospinal fluid
  • Neuroimages suggesting inflammation (signal abnormality, limbic or extra-temporal)
  • Prior treatment with immune checkpoint inhibitors
  • Patients with autoimmune neurologic disorders may present with multiple movement phenomena, many of which can resemble neurodegenerative disorders, such as Huntington disease. These disorders can manifest in conjunction with autoimmune encephalitic diseases, neoplasms, or infections, or they can be completely idiopathic.

Key testing

Advantages

  • Continuously updated to include clinically actionable antibodies most relevant to patients suspected of having autoimmune movement disorders.
  • Includes several antibodies found only at Mayo Clinic Laboratories: Septin 5, Septin 7, and KLHL11.
  • Advanced methodology provides optimized sensitivity and specificity.
  • Can guide search for cancer and/or treatment selection.

Additional testing

Phenotypic evaluations

Our autoimmune movement disorder evaluation is part of an evolving approach to testing for autoimmune neurological disorders using phenotypic-specific evaluations that include multiple antibodies known for their disease association.

The role of Kelch 11

The groundbreaking discovery — by a team of researchers that included Mayo Clinic scientists — that testicular cancer-associated paraneoplastic encephalitis is caused by KLHL11 autoantibodies paved the way for development of the world’s first evidence-based test to confirm the presence of Kelch-like protein (KLHL11) autoantibodies.

Testicular cancer-associated paraneoplastic encephalitis is often misdiagnosed due to neurological syndrome symptoms preceding tumor detection. Identification of KLHL11 autoantibodies, which seems to be one of the most common paraneoplastic antibodies in men, enables providers to offer specific treatment protocols, such as cancer treatments and immunosuppressive therapies, to manage and treat the disease. Early and accurate diagnosis of this syndrome is critical for disease stabilization and possible reversal.


Novel biomarkers added to movement disorders profile

Andrew McKeon, M.B., B.Ch., M.D., explains how Mayo Clinic Laboratories' expanded movement disorders panel better identifies autoimmune conditions to guide appropriate treatment.

Learn more about how to order this evaluation at your institution.

Articles and resources