Autoimmune axonal neuropathies
The value of a comprehensive phenotype-specific evaluation
Patients with autoimmune neuropathies may have symmetric or asymmetric involvements of the extremities, trunk, and head, including extraocular muscles. Subacute onsets and asymmetric involvements more commonly indicate inflammatory or immune causes rather than inherited or metabolic forms. Other parts of the nervous system may also be affected based on the specific inflammatory or immune-mediated causes.
Because of the overlap of clinical symptoms, we recommend a panel-based approach rather than individual antibody testing. Our comprehensive approach evaluates specific antibodies associated with autoimmune or paraneoplastic neuropathies.
When to consider testing
There are certain important clinical characteristics associated with the antibodies offered in this panel. The managing physician should consider ordering this test if the patient has one of the following clinical features:
- Non-length-dependent or asymmetrical axonal neuropathies resembling either sensory neuronopathy, polyradiculoneuropathy, or another particular neuropathy
- Progressive neuropathies with refractory pain or weight loss where an autoimmune or paraneoplastic etiology is suspected
- Inflammatory CSF with an MRI demonstrating contrast enhancement of roots or nerves
- Subacute axonal neuropathy with co-existing autonomic dysfunction or CNS involvement
- Diffuse myokymia, cramp fasciculation syndromes, or neuromyotonia
- Neuropathy developed as an immune-related adverse event of immune checkpoint inhibitors
Which test should I order?
A Test in Focus
Divyanshu Dubey, M.B.B.S., gives an overview of the autoimmune axonal neuropathy test. He discusses when this testing should be ordered, how this testing compares to other testing approaches, and what clinical action can be taken due to the results of this testing.
Learn more about how to order this evaluation at your institution.