2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification.
- Small blood count
- Differential blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Thyroid parameters – TSH; thyroid autoantibodies.
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
- Determination of vitamin B 1, vitamin B 12, methylmalonic acid (in vitamin B12 deficiency accumulates methylmalonic acid, which is metabolized to methylmalonic acid. (MMA) is metabolized), vitamin E.
- Electrolytes – sodium, potassium
- Carbodeficient transferrin (CDT) ↑ (in chronic alcoholism; positive with consumption of one bottle of wine or three bottles of beer per day)* .
- Borrelia serology: detection of Borrelia IgM and IgG – if Lyme disease is suspected.
- HIV serology
- Lues serology: TPHA test (Treponema pallidum hemagglutination test; screening test) – if syphilis is suspected.
- Rheumatism diagnostics – CRP (C-reactive protein) or BSG (blood sedimentation rate); rheumatoid factor (RF), CCP-AK (cyclic citrulline peptide antibodies), ANA (antinuclear antibodies).
- Uric acid
- Antineuronal antibodies – in suspected paraneoplastic cerebellar degeneration (PCD).
- GAD antibodies – if GAD antibody encephalitis is suspected (GAD = glutamate decarboxylase) but in any case do not allow blackmail.
- CSF puncture (lumbar puncture) for CSF diagnosis – if the biochemical screening has not led to any result; furthermore, among other things, suspected paraneoplastic cerebellar degeneration (PCD), sporadic Creutzfeldt-Jakob disease (sCJD).
- Molecular genetic diagnostics – if sporadic degenerative ataxia is suspected: e.g., exclusion of repeat mutations (spinocerebellar ataxias [SCA], Friedreich’s ataxia [FRDA], FMR1 premutation, RFC1 [CANVAS].
* With abstinence, levels normalize within 10-14 days.
