Neuro appt next week, advice please on labwork
 

I have my neuro followup Monday. I have new ( or just worse) symptoms in left hand/forearm. Tremor, easily fatigued, visible atrophy in muscles compared with my dominant right hand. I had an emg/ncs on my LUE in June 2014 which was "normal."

I am charting out my labs through Liza Jane's spreadsheets. Most of the neuronal antibody tests have not been checked. Are they pre-screened through the ANA (anti-nucleic antibodies?) I've had my ANA checked at least once a year for 12 yrs. I was low-positive once (1:80) 12 yrs ago. Since then, within normal limits. I did test positive for acetylcholine ganglionic receptor antibodies last year (autonomic NS.) Should I just request the whole gamut of neuronal tests be done? I have sensory involvement with motor showing up later to the party.

I feel like I am trying to stop a train by myself.

Hi,
Sorry you are having muscle problems.
The best SLE test out there is done by Exagen "AVISE SLE + connective tissue 2.0". What it says on there site, the doctor should only need to do the ANA once after it comes back positive, follow ups are with some of the antibodies like EC4d and AntidsDNA.
The test is done in tiers, if ANA tests are positive, the lab will test for the additional antibodies, then they rate the levels of the tier 2 tests for overall results.
Jon

The neurronal anitbody tests
 

--are for antibodies specific to antigens of peripheral nerve; they are not part of the usual anti-nuclear antibody panel (or the variations of the anti-nuclear antibodies that are used to look for vascular/connective tissue disease disorders).

See:

http://www.questdiagnostics.com/test...ripheralNeurop

http://neuromuscular.wustl.edu/nother/autoantibody.html

Thanks for the info!