Basal Ganglia Antibodies

Basal Ganglia Antibody testing is performed by a referral laboratory. This assay is only available to members of Oxford University Hospitals NHS Foundation Trust.

The spectrum of disorders associated with ABGA and streptococcal infection includes Sydenham's chorea (prototype), tics (PANDAS), a subset of cases with Tourette's syndrome (TS). Rarely patients, with adult-onset tics, dystonia, and some cases with post-encephalitic Parkinsonism or encephalitis lethargica may also have ABGA.

Anti-basal ganglia antibodies (ABGA) have been found with extrapyramidal movement disorders of the basal ganglia and deep grey matter with post-rheumatic fever chorea (90% sensitivity) and tics being the common manifestations, although dystonia and myoclonus have also been reported in rare incidences.

A small number of patients with an encephalitic phenotype with coexistent parkinsonial features has also been reported in association with ABGA and may be described as an encephalitis-lethargica type disease. However, some patients with this EL like phenotype have been shown to have antiNMDA receptor antibodies.

The sensitivity and specificity of the antibodies in post-streptococcal neurological patients is 80- 90% when compared to normal, neurological and streptococcal infection controls. False positives appear more commonly in patients with other streptococcal immune mediated manifestations such as rheumatic fever and glomerulonephritis.

A small number of patients with complex cerebellar disease of unknown aetiology also have the antibodies.

This assay is performed at a referral laboratory (external users requiring Basal Ganglia Antibody testing are advised to contact the referral laboratory directly):

Neuroimmunology and CSF Laboratory
(Box 76) 9th Floor
UCL Queen Square Institute of Neurology
Queen Square
London WC1N 3BG

Specimen requirements

Serum 1ml; plasma is NOT acceptable

Cost

Price on application

Laboratory turnaround time

28 days

Laboratory method

N/A

Reference range/units

Negative = Low Positive = 5-30U/ml

Associated tests

N/A

Shipping and storage

Internal hospital transport/courier.
Ensure delivery Monday to Friday 07:00 - 17:30.

Further information and contact details

For further information, email immunology.office@nhs.net