Autoimmune encephalitis and myelitis are increasingly recognized as causes of central nervous system (CNS) disease in children and teens under age 18. While NMDA-R encephalitis and MOG autoimmunity are most common in children, other entities, including aquaporin-4 (AQP4) autoimmunity, CASPR2 autoimmunity, autoimmune GFAP astrocytopathy, and paraneoplastic encephalomyelopathies, may also occur.
An evaluation designed specifically for children
This first-of-its-kind profile includes only the antibodies
that are pertinent to pediatric CNS disorders—all in
one evaluation. The antibodies included are supported
by clinical research, and the results of this testing can
help with diagnosis and long-term treatment planning.
MOG antibody is 11 times more common
than AQP4 antibody in children.
Testing in serum vs. spinal fluid
At Mayo Clinic Laboratories, we recommend testing in both serum and spinal fluid. Certain antibodies (e.g., NMDA) are more specifically detected in spinal fluid and not in serum. This is especially the case in children with autoimmune encephalitis. If testing is not performed on both specimen types, autoantibodies could be missed and medical errors could occur.
When to consider testing
Consider testing for children under 18 with suspected autoimmune encephalitis,
or other autoimmune presentation such as ataxia or autoimmune encephalomyelitis,
with one or more of the following:
- Rapid onset and progression of symptoms over weeks to months.
- Behavioral changes such as unrelenting crying spells or tantrums—with or without clear cause—usually accompanied by one or more of the following: confusion, headaches, altered awareness, or movement disorder.
Which test should I order?
A Test in Focus
Autoimmune encephalitis and myelitis is increasingly recognized as a cause of CNS disease in children and teens. Andrew McKeon, M.B., B.Ch., M.D, gives an overview of this test available through Mayo Clinic Laboratories. 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.
Plasma membrane specificities
Nuclear and cytoplasmic specificities
Webinar - Pediatric CNS Disorders
This “Specialty Testing” webinar addresses the clinical presentations, evaluation (including diagnostic antibody testing), and treatment of autoimmune pediatric CNS disorders, including encephalitides and myelopathies.