Abstract Details

Title From Fragmentation to Standardization: Developing an Outpatient Autoimmune Neurology Clinic

Topic Autoimmune Neurology

Presentation(s) P3 - Poster Session 3 (11:30 AM-12:30 PM)

Poster/Presentation
Number 1-065

Objective To describe the development of a rapid-access outpatient autoimmune neurology clinic using scalable workflows and clinical scoring tools, and to evaluate its impact on timeliness, diagnostic accuracy, and standardization of care for suspected autoimmune encephalitis (AE) and paraneoplastic neurologic syndromes (PNS).

Background Care for patients with suspected AE and PNS is often fragmented, leading to delayed diagnosis, unnecessary testing, and inconsistent use of validated diagnostic frameworks. Dedicated subspecialty clinics may improve efficiency and diagnostic accuracy, but practical models and implementation strategies remain underreported.

Design/Methods We established a rapid-access outpatient autoimmune neurology clinic using structured referral triage, templated documentation, and coordinated diagnostic pathways. Standardization included systematic application of APE2 and PNS-CAREs scores to guide diagnostic testing and antibody interpretation. We retrospectively analyzed 50 consecutive patients, evaluating the time to evaluation, time to diagnostic studies (MRI, EEG, lumbar puncture, malignancy screening) using clinic workflows versus pre-referral timelines, antibody panel utilization, and concordance between referral and final diagnoses.

Results Fifty patients were evaluated following screening of 77 referrals. The mean time to first appointment was 17 days. Most patients had extensive prior workup, including neuroimaging and antibody testing. The clinic model enabled systematic reinterpretation of prior results and reduced time to key diagnostic studies including MRI Brain, EEG, and lumbar puncture. Twenty-two percent of serum and 25% of CSF antibody panels required repeat testing for gold-standard assessment. The application of APE2 and PNS-CAREs scores improved diagnostic stratification and reduced unnecessary testing. Referral diagnoses were frequently revised following standardized evaluation, highlighting variability in pre-referral diagnostic accuracy.

Conclusions A structured autoimmune neurology clinic model enables standardized, high-value evaluation of suspected AE and PNS. Integration of clinical scoring systems, centralized data review, and coordinated diagnostic workflows improved consistency in antibody testing and diagnostic decision-making. This model provides a scalable framework for other centers seeking to develop subspecialty autoimmune neurology programs.

Authors/Disclosures
Sarah E. Fredrich, MD (University of Maryland Baltimore) PRESENTER	Dr. Fredrich has nothing to disclose.
Haroon Z. Ahmad, MD (University of Maryland, Neurology)	Dr. Ahmad has nothing to disclose.
Lily Pham, MD (University of Maryland)	Dr. Pham has nothing to disclose.
David R. Benavides, MD, PhD, FAAN (University of Maryland School of Medicine)	The institution of Dr. Benavides has received research support from F. Hoffman La Roche Ltd.

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