Blood Tests for Neurological Disorders

Blood tests monitor levels of therapeutic drugs used to treat neurological disorders, identify the medical causes of neuropathy, and help diagnose dementia and or rule out medical conditions adversely affecting the neurological system. 

Order your lab tests for neurological disorders today, and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests. Take control with Ulta Lab Tests today!


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The tricyclics are used to treat depression. Nortriptyline is an active metabolite of Amitriptyline. Therapeutic drug levels are monitored to assist the physician assessing therapeutic response and to avoid toxicity.


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Clinical Significance

Aripiprazole (Abilify®) is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression. The analysis of aripiprazole is used to monitor compliance with drug therapy.


Increased CRP levels are found in inflammatory conditions including: bacterial infection, rheumatic fever, active arthritis, myocardial infarction, malignancies and in the post-operative state. This test cannot detect the relatively small elevations of CRP that are associated with increased cardiovascular risk.

Carnitine, LC/MS/MS Includes: Carnitine, Total; Carnitine, Free; Carnitine, Esters; Esterified/Free Ratio

 

Clinical Significance

Serum carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency (either primary or secondary). Primary carnitine deficiency is an autosomal recessively inherited genetic condition that affects carnitine uptake by cells and tissues through a defect in the plasma membrane carnitine transporter. Secondary carnitine deficiency can be seen in some disease states or in patients on carnitine-poor diets, but is also seen in a number of metabolic disorders. In these disorders, carnitine complexes with the accumulated substrate of the blocked metabolic step, and the resulting acylcarnitine ester is excreted in the urine, leading to a depletion of carnitine in the patient


A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Comprehensive Metabolic Panel


The Digestive Health - Advanced contains the following tests

  • C-Reactive Protein (CRP) 
  • CBC (includes Differential and Platelets) 
  • Comprehensive Metabolic Panel (CMP)
  • Fecal Globin by Immunochemistry (InSure®) 
  • Ferritin
  • Folate, Serum
  • Iron and Total Iron Binding Capacity (TIBC)
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS 
  • Transferrin
  • Vitamin B12 (Cobalamin) 
  • Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.


If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.


Digestive Health - Basic contains the following tests

  • CBC (includes Differential and Platelets) 
  • Comprehensive Metabolic Panel (CMP)
  • Fecal Globin by Immunochemistry (InSure®) 
  • Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.


If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.


Digestive Health - Basic Plus contains the followwing tests: 

  • C-Reactive Protein (CRP) 
  • CBC (includes Differential and Platelets) 
  • Comprehensive Metabolic Panel (CMP)
  • Fecal Globin by Immunochemistry (InSure®) 
  • Ferritin
  • Iron and Total Iron Binding Capacity (TIBC)
  • Celiac Disease Comprehensive Panel (w/ Reflexes)

 Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.


If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.


Digestive Health - Comprehensive contains the following tests: 

  • C-Reactive Protein (CRP) 
  • CBC (includes Differential and Platelets) 
  • Comprehensive Metabolic Panel (CMP)
  • Fecal Globin by Immunochemistry (InSure®) 
  • Ferritin
  • Folate, Serum
  • Gliadin (Deamidated Peptide) Antibody (IgA) 
  • Gliadin (Deamidated Peptide) Antibody (IgG) 
  • Iron and Total Iron Binding Capacity (TIBC)
  • Lipid Panel with Ratios
  • Magnesium
  • Prealbumin 
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS 
  • Transferrin
  • TSH
  • Vitamin A (Retinol)
  • Vitamin B12 (Cobalamin) 
  • Vitamin K
  • Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.


If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age, 

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.


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Serum glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolic disorders including diabetes mellitus, idiopathic hypoglycemia, and pancreatic islet cell neoplasm.

Imipramine is a tricyclic antidepressnt drug used to treat depression. Therapeutic drug monitoring is used to optimize dose and to avoid toxicity.

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The methylmalonic acid (MMA) test may be used to help diagnose an early or mild vitamin B12 deficiency. It may be ordered by itself or along with a homocysteine test as a follow-up to a vitamin B12 test result that is in the lower end of the normal range.


Methylmalonic acid is metabolized as methylmalonyl CoA from the catabolism of certain amino acids and fatty acids. Methylmalonyl CoA is then converted to Succinic acid by the following reaction: Methylmalonic Acid Methylmalonyl CoA Mutase + B12 Succinic Acid The enzyme Methylmalonyl CoA mutase requires Vitamin B12 (Cobalamin) as a cofacter. MMA is used to evaluate cobalamin deficiency. Elevated serum MMA reflects decreased tissue cobalamin levels and is an early indicator of vitamin B12 deficiency. Cobalamin dependent neurological disease with normal hematologic parameters and serum B12 levels is frequently associated with significant elevations of serum methylmalonic acid. Methylmalonic Acidemia is an autosomal recessive inborn error of metabolism, in which there is a deficiency of the enzyme methylmalonyl CoA mutase, resulting in a large accumulation of MMA in serum and urine. There is also a combined defect in the cobalamin pathway with elevation of both MMA and homocysteine.


Useful in the diagnosis of Myasthenia Gravis

Myasthenia Gravis is a neurological disorder characterized by a decrease in acetylcholine receptors. Patients exhibit skeletal muscle weakness and fatigability. Approximately 80% of patients with Myasthenia Gravis, excluding ocular involvement only, have detectable acetylcholine receptor antibody.

Acetylcholine Receptor Binding Antibody
Acetylcholine Receptor Blocking Antibody
Acetylcholine Receptor Modulating Antibody


Antibodies against myelin are found in multiple sclerosis and other neurological diseases. However, the diagnostic value of this serum antibody is controversial, as high titers in healthy subjects can also be detected. Antibodies against myelin-associated glycoproteins are present at times with Guillain-Barre syndrome.


Myelin Associated Glycoprotein (MAG)-SGPG Antibody (IgM)

Myelin associated glycoprotein (MAG) and sulphated glucuronyl paragloboside (SGPG) antibodies are present in a subgroup of sensory demyelinating neuropathies. Axonal neuropathies can present with only monoclonal IgM anti-SGPG activity. Presence of anti-SGPG antibodies alone is more characteristic of axonal non-demyelinating neuropathy. There is a relationship between the titer of anti-MAG antibodies and the degree of demyelination.

Result Name: MAG SGPG AB (IGM),EIA

Component Name: Myelin associated glycoprotein-sulfated glucuronic paragloboside Ab.IgM

 



Sensory-Motor Neuropathy Antibody Panel (Ganglioside) 

 

Includes

Ganglioside GM-1 Antibodies (IgG, IgM), EIA; Ganglioside GD1a Antibody (IgG, IgM), EIA; Ganglioside GD1b Antibody (IgG, IgM), EIA; Ganglioside GQ1b Antibody (IgG), EIA; Ganglioside Asialo-GM-1 Antibody (IgG, IgM), EIA

 

Clinical Significance

The presence of antibodies to the gangliosides GM1, Asialo-GM1, GD1a and GD1b has been associated with motor and sensorimotor neuropathies. High titers of antibody to GM1 are most typical of multifocal motor neuropathy; however, antibodies to other gangliosides are often present. In most cases of chronic immune neuropathies, anti-ganglioside antibodies are IgM class. IgG antibodies have been reported less often, generally associated with acute conditions. Many reports have found increased anti-asialo-GM1 antibody titers in patients with multifocal motor neuropathy, lower motor neuron disease, sensorimotor neuropathy, or motor neuropathy with or without multifocal block, Guillain-Barré Syndrome, and amyotrophic lateral sclerosis. There may be a relationship between titers of asialo-GM1 antibodies and clinical status in individual patients. In some lower motor neuron disorders, improvement in strength has occurred after therapeutic reduction in anti-asialo-GM1 antibody titers. Polyclonal GQ1b IgG antibody can serve as an aid in the diagnosis of acute ataxia neuropathy with ophthalmoplegia or of Miller-Fisher Syndrome.