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Sera that reacted with leucine-rich glioma-inactivated protein 1 (LGI1), contactin-associated protein-2 (CASPR2), or the voltage-gated potassium channel (VGKC) complex were retested for LGI1 and CASPR2 antibodies by another laboratory. Physicians in charge of patients with positive antibody results retrospectively reported on clinical, treatment, and outcome parameters.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Positive results were obtained for 576 patients (5.3%). Median disease duration was 6\u00a0months (interquartile range 0.6\u201346\u00a0months). In most patients, antibodies were detected both in CSF and serum. However, in 16 (28%) patients with <jats:italic>N<\/jats:italic>-methyl-<jats:sc>d<\/jats:sc>-aspartate receptor (NMDAR) antibodies, this diagnosis could be made only in cerebrospinal fluid (CSF). The two laboratories agreed largely on LGI1 and CASPR2 antibody diagnoses (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.95). The clinicians (413 responses, 71.7%) rated two-thirds of the antibody-positive patients as autoimmune. Antibodies against the \u03b1-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), NMDAR (CSF or high serum titer), \u03b3-aminobutyric acid-B receptor (GABABR), and LGI1 had\u2009\u2265\u200990% positive ratings, whereas antibodies against the glycine receptor, VGKC complex, or otherwise unspecified neuropil had\u2009\u2264\u200940% positive ratings. Of the patients with surface antibodies, 64% improved after\u2009\u2265\u20093\u00a0months, mostly with\u2009\u2265\u20091 immunotherapy intervention.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This novel approach starting from routine diagnostics in a dedicated laboratory provides reliable and useful results with therapeutic implications. Counseling should consider clinical presentation, demographic features, and antibody titers of the individual patient.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-020-09814-3","type":"journal-article","created":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T12:04:41Z","timestamp":1585915481000},"page":"2101-2114","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Routine diagnostics for neural antibodies, clinical correlates, treatment and functional outcome"],"prefix":"10.1007","volume":"267","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2225-8654","authenticated-orcid":false,"given":"Christian G.","family":"Bien","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna I.","family":"Bien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00fcjgan","family":"Dogan Onugoren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3705-8903","authenticated-orcid":false,"given":"Desiree","family":"De Simoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Eigler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6479-0265","authenticated-orcid":false,"given":"Carl-Albrecht","family":"Haensch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Holtkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-8056","authenticated-orcid":false,"given":"Fatme S.","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kurthen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Melzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3134-8697","authenticated-orcid":false,"given":"Felix","family":"von Podewils","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Rauschka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7878-172X","authenticated-orcid":false,"given":"Andrea O.","family":"Rossetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf-R\u00fcdiger","family":"Sch\u00e4bitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Simova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Witt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5769-1100","authenticated-orcid":false,"given":"Romana","family":"H\u00f6ftberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6517-9425","authenticated-orcid":false,"given":"Theodor W.","family":"May","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,3]]},"reference":[{"key":"9814_CR1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1212\/WNL.0000000000003009","volume":"87","author":"H Ari\u00f1o","year":"2016","unstructured":"Ari\u00f1o H, Armangue T, Petit-Pedrol M, Sabater L, Martinez-Hernandez E, Hara M, Lancaster E, Saiz A, Dalmau J, Graus F (2016) Anti-LGI1-associated cognitive impairment: presentation and long-term outcome. 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He receives research support from Deutsche Forschungsgemeinschaft (German Research Council, Bonn, Germany) and Gerd-Altenhof-Stiftung (Deutsches Stiftungszentrum, Essen, Germany). Dr. M Holtkamp obtained speaker\u2019s honoraria and\/or consultancy fees from Arvelle, Bial, Desitin, Eisai, GW Pharmaceuticals, Novartis, and UCB. Dr. N Melzer has received honoraria for lecturing and travel expenses for attending meetings from Biogen Idec, GlaxoSmith Kline, Teva, Novartis Pharma, Bayer Healthcare, Genzyme, Alexion Pharmaceuticals, Fresenius Medical Care, Diamed, and BIAL, and has received financial research support from Euroimmun, Fresenius Medical Care, Diamed, Alexion Pharmaceuticals, and Novartis Pharma. Dr. F von Podewils obtained honoraria for speaking engagements from UCB, Eisai, and BIAL. Dr H Rauschka obtained honoraria for speaking engagements, consulting, serving on advisory boards and funding for conference travels from Biogen, Merck, Novartis, Roche, Sanofi and Teva-Ratiopharm. Dr. R H\u00f6ftberger obtained honoraria for speaking engagements from Euroimmun and Novartis. She receives research support from the Jubil\u00e4umsfonds der \u00d6sterreichischen Nationalbank, Project 16919, and the GBS\/CIDP Foundation International. The Medical University of Vienna receives payments for antibody assays. The other authors report no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study was approved by the Ethics committee of the University of M\u00fcnster, Germany (2017\u2013005-f-S).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable (retrospective evaluation, waived by Ethics committee).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable (retrospective evaluation, waived by Ethics committee).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Any data not published within this article are available at the Epilepsy Center Bethel. Data will be shared upon request from any qualified investigator, maintaining anonymization of the patients.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data and material"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}}]}}