Neuroradiological leukoencephalopathy work-up
Screening tests
Serum glucose, electrolytes, calcium/phosphorus, liver,
renal and thyroid
function tests
Protein and immunoelectrophoresis
CBC, ESR, coagulation profile
Antibodies: ANA, ENA, ANCA, RF, complement, ACE, anti-thyroglobulin and anti-thyroperoxidase (Hashimoto disease), anti-cardiolipin, anti-phospholipid, anti-lupus antibodies
Serum vitamin B12 and RBC folate and homocysteine.
RPR,
TPHA
Serology: HIV, hepatitis (A,B,C), toxoplasma, Lyme, cysticercosis, IgM measles.
Urinary organic acids (glutaric acid (normal value <10 mmol/mol creatinine) and 3-hydroxyglutaric acid (normal value <10 mmol/mol creatinine).
Chest X-ray, CT chest
PPD
Echocardiogram
EEG (non-convulsive status epilepticus)
Brain MRI, MRA, angiography
CSF
Besides routine analysis (chemistry, cell count, smear and stainings): lactate and pyruvate, oligoclonal bands, IgG index, VDRL, viral (IgM measles titer), fungal, Ziehl staining, repeated cytology, CSF antibodies against T. solium can be measured by serum enzyme-linked immunoelectrotransfer blot, anti-thyroglobulin and anti-thyroperoxidase antibodies (Hashimoto).
Biopsy
Brain biopsy, muscle/nerve biopsy.
DNA testing
DNA mutational analysis, PCR TB, T. Whippelii (on small bowel biopsy), mutational analysis exon 4 of EIF2B5 (Adult-onset leukoencephalopathy with vanshing white matter)