Overview

Up-to-date, comprehensive, and beautifully illustrated, Laboratory Diagnosis in Neurology presents all the measuring parameters and methods relevant to the analysis of cerebrospinal fluid, serum, and tissues affected by neurologic disease and syndromes. Following an introduction to basic concepts, the book guides clinicians through the methods of CSF analysis, neurochemical examinations, clinical applications of neuroimmunology, microbiology and virology, neurogenetic tests, and evaluation of biopsies. Readers ...
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Laboratory Diagnosis in Neurology

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Overview

Up-to-date, comprehensive, and beautifully illustrated, Laboratory Diagnosis in Neurology presents all the measuring parameters and methods relevant to the analysis of cerebrospinal fluid, serum, and tissues affected by neurologic disease and syndromes. Following an introduction to basic concepts, the book guides clinicians through the methods of CSF analysis, neurochemical examinations, clinical applications of neuroimmunology, microbiology and virology, neurogenetic tests, and evaluation of biopsies. Readers will learn about the equipment and various procedures, and how to effectively differentiate similar methods. In the final section of the book, the authors provide a systematic introduction to the pathophysiology and laboratory findings for specific clinical disorders, indications for particular test methods, and criteria for diagnostic interpretation.Key features:
  • Clear presentation of pearls, pitfalls, and practical tips in blue boxes for at-a-glance review
  • Contributions by neurologists, psychiatrists with experience in laboratory analysis, clinical chemists, and neurochemists
  • More than 140 high-quality illustrations, mostly in full color, demonstrating common findings
  • Appendix with basic rules for interpreting disease-specific patterns, recommendations for quality control, and a list of the most important reference values
  • An indispensable tool for neurologists, laboratory physicians, and pathologists, this book is also a valuable reference for neurosurgeons, internists, and psychiatrists.
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Product Details

  • ISBN-13: 9783131495716
  • Publisher: Thieme
  • Publication date: 1/1/2011
  • Sold by: Barnes & Noble
  • Format: eBook
  • Edition number: 1
  • Pages: 296
  • File size: 8 MB

Meet the Author

Professor, Dept. of Molecular Neuroimmunology, Neurological University Clinic, Heidelberg University, Heidelberg, Germany

Professor, Dept. of Neurology, Bayreuth Hospital, Bayreuth, Germany

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Table of Contents

Basics 1

1 Cerebrospinal Fluid: Spaces, Production, and Flow H. Reiber Reiber, H. 3

2 Blood-Brain Barrier and Blood-CSF Barrier Function H. Reiber Reiber, H. 5

Blood-Brain Barrier 5

The Blood-CSF Barrier Function 5

3 Dynamics of Serum and Brain Proteins in CSF and Blood H. Reiber Reiber, H. 10

Serum Proteins in CSF 10

Brain Proteins in CSF 12

Brain Proteins in Blood 13

Analysis 15

4 Principles of Analytical Methods H. Reiber Reiber, H. 17

Immunochemistry 17

Antigen-Antibody Binding 17

Methods of Immune Complex Analysis 18

Qualitative Electrophoretic Methods with or without Immunodetection 23

Relevance and Principle of Electrophoresis 23

Protein Electrophoresis 24

SDS Gel Electrophoresis (One-Dimensional) 24

Isoelectric Focusing 24

Electrophoresis Gels 25

Electrophoretic Methods with Immunodetection 26

Detection of Oligoclonal IgG Bands 28

Immunohistochemistry 29

5 Cerebrospinal Fluid Analysis M. Otto Otto, M. 30

Cerebrospinal Puncture B. Storch-Hagenlocher Storch-Hagenlocher, B. 30

Measurement of Cerebrospinal Pressure B. Storch-Hagenlocher Storch-Hagenlocher, B. 34

Cell count, Cytology B. Storch-Hagenlocher Storch-Hagenlocher, B. 35

Indications 35

Preanalytical Requirements 35

Procedures 36

Findings 38

Proteins H. Reiber Reiber, H. 44

Total Protein 44

CSF/Serum Albumin Quotient 45

Immunoglobulins 46

Quotient Diagrams (Reibergrams) 48

Statistics for Groups in Quotient Diagrams 51

Oligoclonal IgG 53

Antibody Index 54

Relative Sensitivities of Immunodetection Methods 55

Lactate and Glucose H. Reiber Reiber, H. 56

Lactate 56

Glucose 58

Diagnosis of Pathogens P. Schnitzler Schnitzler, P. 59

General Remarks 59

Microscopic Detection of Pathogens 60

Rapid Antigen Tests 61

Propagation of Pathogens in Culture 63

Detection of Pathogen-Specific Genome Sequences Using Nucleic Acid Amplification Techniques 65

Antibody Detection 68

Markers of Dementia and Neuronal Destruction M. Otto Otto, M. 69

6 Serum Analysis M. Uhr Uhr, M. 73

General Serum Analysis M. Zorn Zorn, M. 73

Inflammation Markers 73

Angiotensin-Converting Enzyme (ACE) 75

Ceruloplasmin (Cp) 76

Folic Acid and Vitamin B12 (Cobalamins) 76

Diabetes Markers 77

Alcohol Markers 77

Endocrine Markers 78

Atherosclerosis Markers 78

Creatine Kinase (CK) 80

Neuron-Specific Enolase (NSE) and S-100 Protein 80

Special Serum Analysis M. Uhr Uhr, M. 81

Determination of Drug Levels 81

Intoxication 83

Determination of Vitamins 83

7 Autoantibodies and Antineural Antibodies U. Wurster Wurster, U. 86

Autoantibodies B. Wildemann Wildemann, B. 86

Antineural Antibodies U. Wurster Wurster, U. 91

8 Neurogenetics T. Gasser Gasser, T. 99

Basics 99

Monogenic Hereditary Neurological Disorders 103

Polygenic or Multifactorial Hereditary Neurological Disorders 104

9 Biopsy H. Tumani Tumani, H. 108

Brain Biopsy 108

Nerve Biopsy 108

Muscle Biopsy 109

Basics 109

Typical Muscle Biopsy Findings 112

Clinical Pictures 115

10 Inflammatory and Autoimmune Diseases B. Wildemann Wildemann, B. 117

Infections 117

Bacterial Infections B. Storch-Hagenlocher Storch-Hagenlocher, B. 117

Abscesses B. Storch-Hagenlocher Storch-Hagenlocher, B. 121

Ventriculitis B. Storch-Hagenlocher Storch-Hagenlocher, B. 122

Viral Infections of the Nervous System P. Oschmann Oschmann, P. 123

Infection of the Nervous System by Fungi and Other Opportunistic Pathogens P. Oschmann Oschmann, P. 128

Neuroborreliosis P. Oschmann Oschmann, P. 130

Neurosyphilis P. Oschmann Oschmann, P. 133

Chronic Infections of the Nervous System P. Oschmann Oschmann, P. 135

Non-Pathogen-Related Inflammatory Disorders: Autoimmune Diseases B. Wildemann Wildemann, B. 138

Multiple Sclerosis 138

Acute Demyelinating Encephalomyelitis and MS Variants 141

Neurosarcoidosis 141

Stiff Person Syndrome and Other Neurological Diseases Associated with GAD Antibodies 143

Myasthenia Gravis and Other Disorders of Neuromuscular Transmission 144

Lambert-Eaton Myasthenic Syndrome 145

Neuromyotonia 145

Polymyositis, Dermatomyositis, and Inclusion Body Myositis 146

Guillain-Barre Syndrome and Other Immune-Mediated Neuropathies 147

Systemic Vasculitis and Connective Tissue Diseases 154

Paraneoplastic Neurological Syndromes 159

11 Dementia and Other Psychiatric Disorders M. Uhr Uhr, M. 166

Alzheimer's Disease M. Otto Otto, M. 166

Lewy Body Dementia M. Otto Otto, M. 170

Frontotemporal Lobar Degeneration M. Otto Otto, M. 171

Multiple System Atrophy M. Otto Otto, M. 173

Subcortical Arteriosclerotic Encephalopathy M. Otto Otto, M. 173

Creutzfeldt-Jakob Disease M. Otto Otto, M. 174

Psychiatric Disorders M. Uhr Uhr, M. 176

12 Cerebral Ischemia and Hemorrhage P. Oschmann Oschmann, P. 179

Ischemic Cerebral Infarction 179

Intracerebral Hemorrhage 182

Subarachnoid Hemorrhage 183

Cerebral Hypoxia 185

13 Polyneuropathies B. Wildemann Wildemann, B. 187

14 Pseudotumor Cerebri, Ventricular Drainage, and Neurosurgery P. Oschmann Oschmann, P. 194

Pseudotumor Cerebri 194

External Ventricular Drainage, Ventriculoatrial and Ventriculoperitoneal Shunts 194

Diagnosis of Cerebrospinal Rhinorrhea and Otorrhea 195

15 Epileptic Seizures H. Tumani Tumani, H. 197

16 Brain Tumors M. Vogt-Schaden Vogt-Schaden, M. 200

Primary Brain Tumors B. Storch-Hagenlocher Storch-Hagenlocher, B. 200

Secondary Brain Tumors M. Vogt-Schaden Vogt-Schaden, M. 202

Neoplastic Meningitis in Malignant Non-Hodgkin Lymphoma and Leukemia M. Vogt-Schaden Vogt-Schaden, M. 205

Malignant Non-Hodgkin Lymphoma 205

Leukemia 205

Lymphomatous Meningitis 205

17 Metabolic Diseases F. Ebinger Ebinger, F. 209

Mitochondrial Diseases 211

Lysosomal Diseases 216

Peroxisomal Diseases 222

Cerebrotendinous Xanthomatosis 223

Leukodystrophy/Leukoencephalopathy in Organic Aciduria 224

Disorders of Copper Metabolism 224

18 Parasitoses and Tropical Diseases E. Schmutzhard Schmutzhard, E. 226

Appendix 233

19 CSF Analysis Report H. Reiber Reiber, H. 235

Integrated CSF Report 235

CSF Analysis Procedure 235

Evaluation 238

Interpretation 246

20 Quality Assessment in the CSF Laboratory H. Reiber Reiber, H. 249

Quality Assessment in Laboratory Medicine 249

Internal Quality Control for CSF proteins (Total Protein, Albumin, IgG, IgA, IgM) 250

The INSTAND Interlaboratory CSF Survey 251

EQA for CSF proteins (Total Protein, Albumin, IgG, IgA, IgM) 251

CSF Survey: Specific Antibodies in CSF and Serum 252

CSF Survey: Oligoclonal IgG 252

Manufacturer-Related Versus Patient-Related Evaluation in Interlaboratory Surveys 252

CSF Survey: Lactate, Glucose and Surrogate Markers 253

CSF Cytology: Quality Control and Interpretation Training 253

21 Reference Ranges of Analytes in CSF and Serum H. Reiber Reiber, H. 254

Electrolytes and Substrates 254

Proteins 254

Amino Acids, Lipids, and Vitamins 254

Cells 255

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