The aim of the present study is to identify the range of
neurological disorders expressing antineuronal
antibodies, evaluate the number of different patterns of reactivity that can be detected, and analyse the contribution of these studies to the identification of subgroups of patients. The records of 882 patients were reviewed and their sera and cerebrospinal fluids tested for antineuronal
antibodies. Patients were initially divided into four groups according to suspected clinical diagnosis.
Autoantibodies were detected by immunohistochemistry, Western blot of gradient-separated neuronal and
recombinant proteins and by RIA. Cerebellar degeneration and sensory neuropathies were the most common
neurological disorders in which paraneoplastic-related anti-neuronal
antibodies were detected. However, in addition to PCA1/anti-Yo and ANNA1/anti-Hu
antibodies, we found other reactivities in six patients with cerebellar degeneration: anti-GAD in three females and atypical in the other cases. The widest range of different anti-neuronal
antibodies was detected in patients with peripheral sensory neuropathy. Few patients with
Stiff-Person syndrome,
temporal lobe epilepsy and
myoclonus harboured anti-GAD
antibodies. Atypical
antibodies were detected in single cases with motor neuron disorder and
multiple system atrophy. No anti-neuronal
antibodies were detected in patients with neurological complications of connective tissue disorders other than Sjögren's syndrome, or in neurological diseases other than
motor neuron disease and
multiple system atrophy. Our study shows that the spectrum of
neurological disorders in which anti-neuronal
antibodies can be detected is wider than previously thought. In addition, we found patterns of neuronal staining and Western blot reactivity that differed from those so far reported. This may permit identification of subgroups of patients in whom strategies directed at removing and/or suppressing antibody production could be of some benefit.