In all patients: |
Brain MRI, including FLAIR and DWI, with and without gadolinium enhancement |
Serum electrolytes, liver, renal, and thyroid function tests |
Vitamin B12, homocysteine |
Urinalysis, culture |
In most patients: |
Lumbar puncture, cell count and differential, protein, glucose, syphilis serology |
EEG |
In selected patients (based on abnormalities in above tests or suggestive clinical features): |
CSF |
Cryptococcal antigen |
Bacterial fungal AFB stains and cultures |
Cytology |
Viral PCRs and cultures |
Lyme serology |
14-3-3 protein |
Paraneoplastic antibodies |
Blood |
Rheumatologic screen (ESR, ANA, CRP) |
Antithyroglobulin, anti-thyroperoxidase antibodies |
HIV |
Lyme |
Paraneoplastic and nonparaneoplastic autoimmune antibodies |
Copper, ceruloplasmin |
Whipple PCR |
Urine copper, heavy metal screen |
Further imaging (angiography, PET, SPECT) |
Brain biopsy |
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