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LIBRERIA STUDIUM
Laboratory Diagnosis in Neurology
Wildemann, Oschmann, Reiber
Editore
Thieme
Anno
2010
Pagine
271
ISBN
9783131441010
110,00 €
A practice-oriented reference for the laboratory diagnosis of neurologic diseases
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.
Contents
Basics · 1
1 Cerebrospinal Fluid: Spaces, Production, and Flow · 3
H. Reiber
2 Blood–Brain Barrier and Blood–CSF Barrier Function · 5
H. Reiber
Blood–Brain Barrier · 5 The Blood–CSF Barrier Function · 5
3 Dynamics of Serum and Brain Proteins in CSF and Blood · 10
H. Reiber
Serum Proteins in CSF · 10
Brain Proteins in CSF · 12
Brain Proteins in Blood · 13
Analysis · 15
4 Principles of Analytical Methods · 17
H. Reiber
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 · 30
B. Storch-Hagenlocher, H Reiber, B. Wildemann, M. Otto
Cerebrospinal Puncture · 30
B. Storch-Hagenlocher
Measurement of Cerebrospinal Pressure · 34
B. Storch-Hagenlocher
Cell count, Cytology · 35
B. Storch-Hagenlocher
Indications · 35
Preanalytical Requirements · 35
Procedures · 36
Findings · 38
aus: Wildemann, Laboratory Diagnosis in Neurology (ISBN 9783131441010) © 2010 Georg Thieme Verlag KG
XIV Contents
Proteins · 44
H. Reiber
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 · 56
H. Reiber
Lactate · 56
Glucose · 58
Diagnosis of Pathogens · 59
B. Wildemann, H. K. Geiss, P. Schnitzler
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 · 69
M. Otto
6 Serum Analysis · 73
M. Zorn, M. Uhr
General Serum Analysis · 73
M. Zorn
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 · 81
M. Uhr
Determination of Drug Levels · 81
Intoxication · 83
Determination of Vitamins · 83
7 Autoantibodies and Antineural Antibodies · 86
B. Wildemann, U. Wurster
Autoantibodies · 86
B. Wildemann
Antineural Antibodies · 91
U. Wurster
8 Neurogenetics · 99
T. Gasser
Basics · 99
Monogenic Hereditary Neurological Disorders · 103
Polygenic or Multifactorial Hereditary Neurological
Disorders · 104
9 Biopsy · 108
A. Rosenbohm, A. Sperfeld, H. Tumani
Brain Biopsy · 108
Nerve Biopsy · 108
Muscle Biopsy · 109
Basics · 109
Typical Muscle Biopsy Findings · 112
aus: Wildemann, Laboratory Diagnosis in Neurology (ISBN 9783131441010) © 2010 Georg Thieme Verlag KG
Contents XV
Clinical Pictures · 115
10 Inflammatory and Autoimmune Diseases · 117
B. Storch-Hagenlocher, P. Oschmann, B. Wildemann
Infections · 117
Bacterial Infections · 117
B. Storch-Hagenlocher
Abscesses · 121
B. Storch-Hagenlocher
Ventriculitis · 122
B. Storch-Hagenlocher
Viral Infections of the Nervous System · 123
P. Oschmann
Infection of the Nervous System
by Fungi and Other Opportunistic Pathogens · 128
P. Oschmann
Neuroborreliosis · 130
P. Oschmann
Neurosyphilis · 133
P. Oschmann
Chronic Infections of the Nervous System · 135
P. Oschmann
Non-Pathogen-Related Inflammatory Disorders:
Autoimmune Diseases · 138
B. Wildemann
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-Barré Syndrome and Other Immune-Mediated
Neuropathies · 147
Systemic Vasculitis and Connective Tissue Diseases · 154
Paraneoplastic Neurological Syndromes · 159
11 Dementia and Other Psychiatric Disorders · 166
M. Otto, M. Uhr
Alzheimer’s Disease · 166
M. Otto
Lewy Body Dementia · 170
M. Otto
Frontotemporal Lobar Degeneration · 171
M. Otto
Multiple System Atrophy · 173
M. Otto
Subcortical Arteriosclerotic Encephalopathy · 173
M. Otto
Creutzfeldt-Jakob Disease · 174
M. Otto
Psychiatric Disorders · 176
M. Uhr
12 Cerebral Ischemia and Hemorrhage · 179
E. Stolz, P. Oschmann
Ischemic Cerebral Infarction · 179
Intracerebral Hemorrhage · 182
Subarachnoid Hemorrhage · 183
Cerebral Hypoxia · 185
13 Polyneuropathies · 187
B. Wildemann
aus: Wildemann, Laboratory Diagnosis in Neurology (ISBN 9783131441010) © 2010 Georg Thieme Verlag KG
XVI Contents
14 Pseudotumor Cerebri, Ventricular Drainage, and Neurosurgery · 194
E. Stolz, P. Oschmann
Pseudotumor Cerebri · 194
External Ventricular Drainage, Ventriculoatrial and
Ventriculoperitoneal Shunts · 194
Diagnosis of Cerebrospinal Rhinorrhea and Otorrhea · 195
15 Epileptic Seizures · 197
J. Brettschneider, H. Tumani
16 Brain Tumors · 200
B. Storch-Hagenlocher, M. Vogt-Schaden
Primary Brain Tumors · 200
B. Storch-Hagenlocher
Secondary Brain Tumors · 202
M. Vogt-Schaden
Neoplastic Meningitis in Malignant Non-Hodgkin
Lymphoma and Leukemia · 205
M. Vogt-Schaden
Malignant Non-Hodgkin Lymphoma · 205
Leukemia · 205
Lymphomatous Meningitis · 205
17 Metabolic Diseases · 209
F. Ebinger
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 · 226
H. Reiber, E. Schmutzhard
Appendix · 233
19 CSF Analysis Report · 235
H. Reiber
Integrated CSF Report · 235
CSF Analysis Procedure · 235
Evaluation · 238
Interpretation · 246
aus: Wildemann, Laboratory Diagnosis in Neurology (ISBN 9783131441010) © 2010 Georg Thieme Verlag KG
Contents XVII
20 Quality Assessment in the CSF Laboratory · 249
H. Reiber
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 · 254
H. Reiber
Electrolytes and Substrates · 254
Proteins · 254
Amino Acids, Lipids, and Vitamins · 254
Cells · 255
