How long does an autoimmune neurology evaluation take?

The first visit is 60 minutes. Antibody panels, MRI, spinal fluid testing, and EEG are scheduled in the weeks that follow, and most people have a working answer within a few weeks, sooner when the presentation is urgent.

What is a neuroimmunologist?

A neurologist with further training in diseases where the immune system attacks the nervous system: autoimmune encephalitis, NMOSD, MOGAD, transverse myelitis, immune neuropathies, and related conditions. Dr. Ntranos completed a fellowship in MS and demyelinating diseases and postdoctoral research in neuroimmunology, and this is the focus of the practice.

Do you treat autoimmune encephalitis?

Yes, outside the acute hospital phase. We evaluate people whose symptoms suggest it before they reach that point, manage immunotherapy after discharge, and reassess diagnoses of dementia, epilepsy, or psychiatric illness that do not fit. Rapidly worsening confusion or a first seizure needs an emergency department first.

Do you treat transverse myelitis, NMOSD and MOG antibody disease?

Yes, outside the acute attack. A new attack, with weakness, numbness or vision loss that builds over hours to days, belongs in an emergency department first. Before and after that, Dr. Ntranos makes the diagnosis, sends the aquaporin-4 and MOG antibody tests to reference laboratories, and manages the long-term treatment that prevents the next attack. Our articles on transverse myelitis and on NMOSD and MOGAD explain how each differs from MS.

What if my symptoms don't turn out to be autoimmune?

Then you have a neurologist who has already taken a full history and examined you. Most people evaluated for a possible autoimmune cause turn out to have something else, and we continue the workup or refer you to the right specialist.

Can I get a second opinion if I've already been diagnosed elsewhere?

Yes. Second opinions on a diagnosis, a positive antibody result, or whether to continue immunotherapy are a regular part of the practice. Send your records ahead so they can be reviewed before the visit.

Do you give infusions in your office?

No. We prescribe and monitor immunotherapy, and infusion treatments such as immunoglobulin, antibody therapies, and plasma exchange are given at an infusion center or hospital through your insurance. We handle the prior authorization and the scheduling.

Do you see patients from outside Los Angeles?

Yes. In-person visits are in Beverly Hills and Los Angeles, and video visits are available anywhere in California, including Orange County, San Diego, and the Bay Area. Testing can be arranged near you, and a first visit by video works well when imaging and records already exist.

Autoimmune Neurologist & Neuroimmunologist in Los Angeles

Symptoms that came on over days to weeks with no clear cause, or an antibody result nobody has explained, can leave you without a name for what is happening. Autoimmune neurology is care for conditions in which the immune system attacks the brain, spinal cord, optic nerves or peripheral nerves, and it starts with a 60-minute visit that ends with a working diagnosis and a testing plan. Many of these conditions were described only in the last twenty years, are often mistaken for psychiatric illness, epilepsy, or dementia, and are treatable when recognized.

Dr. Achillefs Ntranos, MD trained in this area: a fellowship in multiple sclerosis and demyelinating diseases at Mount Sinai, postdoctoral neuroimmunology research at Johns Hopkins, then Assistant Professor of Neurology at Mount Sinai before founding the clinic in 2022.

What autoimmune neurology is

Antibodies or immune cells target one specific protein in the nervous system, and which protein is attacked determines the illness. Antibodies against a receptor on brain cells cause encephalitis. Antibodies against two proteins, aquaporin-4 and MOG, inflame the optic nerves and spinal cord, causing neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody disease (MOGAD). Antibodies against peripheral nerves cause weakness and numbness that passes for an ordinary neuropathy.

A neuroimmunologist, also called an autoimmune neurologist, is a neurologist with additional training in these conditions. People searching for a brain inflammation doctor, an encephalitis specialist, or a doctor who treats transverse myelitis, NMO (once called Devic's disease) or MOG antibody disease usually mean this. These conditions are distinct from multiple sclerosis, and telling them apart matters because some MS treatments make them worse.

Brain and spinal cord with separate enlarged nerve and antibody illustrations. — Autoimmune neurological conditions affect different parts of the nervous system.

Conditions we evaluate and treat

Condition	What usually points to it
Autoimmune encephalitis: NMDA receptor, LGI1, CASPR2	Confusion, memory loss, new seizures, or psychiatric symptoms over days to weeks
NMOSD (formerly Devic's disease) and MOGAD	Optic nerve and spinal cord inflammation, with aquaporin-4 or MOG antibodies
Transverse myelitis	Numbness, weakness, or bladder change below a level on the spinal cord
Autoimmune epilepsy	New seizures resistant to standard medication, often with memory change
Stiff person syndrome, autoimmune movement disorders	Progressive stiffness and spasms, or new chorea or tremor with no structural cause
Guillain-Barré syndrome and CIDP	Weakness and numbness with lost reflexes, over days in GBS and months in CIDP
Paraneoplastic syndromes	An immune response to a cancer, sometimes one not yet found, attacking nerves

We also see neuroinflammation and nervous system involvement in lupus, Sjögren's, and sarcoidosis. Our autoimmune conditions page goes deeper on each.

Autoimmune encephalitis

In its acute phase this is a hospital condition, and the right place is an emergency department, not an outpatient appointment.

An outpatient neuroimmunologist fits before and after that phase: when symptoms are subacute and the question is whether an autoimmune cause is worth pursuing, when someone is discharged and needs immunotherapy managed, and when a label of dementia or epilepsy does not fit. Our article on autoimmune encephalitis symptoms and diagnosis explains why the speed of onset is the clue and why the diagnosis does not wait for antibody results.

How the evaluation works

The history covers how symptoms began and evolved, infections or vaccinations in the weeks before onset, autoimmune disease in you or your family, cancer history, and what has already been tried. The neurological examination looks for signs that separate an inflammatory process from a degenerative or structural one.

From there we order what the working diagnosis requires: MRI with contrast; spinal fluid by lumbar puncture, arranged at a facility that performs it under fluoroscopy; EEG for suspected seizures; neuropsychological testing for cognitive involvement; a small fiber skin biopsy, performed in our Beverly Hills office; and cancer screening when a paraneoplastic syndrome is possible.

Antibody panels are where the laboratory matters as much as the order. We send them to the reference laboratories that developed and validated the assays, not wherever a local draw station routes them.

Two cautions. A negative panel does not exclude an autoimmune cause: antibody-negative cases exist and are diagnosed on the clinical picture, MRI, and spinal fluid. And a low-level positive in someone whose story does not fit is more often a false positive than a diagnosis. A positive antibody on its own does not make a diagnosis. The clinical picture, the MRI, and the spinal fluid have to fit it too.

Immune dysfunction testing: what we test, and what we do not

The phrase covers two different things. In neurology it means looking for an immune system that is attacking the nervous system: neural antibody panels in blood and spinal fluid, spinal fluid cell counts and oligoclonal bands, MRI with contrast, and where relevant EEG or nerve studies. That is what we do.

It does not mean testing for immunodeficiency, a weakened immune system that causes repeated infections, or for allergy. Those belong to an allergist-immunologist, and we will point you to one if that is the real question. It also does not mean the broad "immune panels" sold by wellness clinics, which rarely change a neurological diagnosis. If you bring one, we are glad to read it in context.

What to expect, visit by visit

First visit, 60 minutes
History, examination, a working diagnosis, and orders for the testing that will test it. Send records ahead through patient tools.
Testing, usually a few weeks
Blood draws can be done locally. MRI, EEG, and lumbar puncture are scheduled in the same window, and we handle the prior authorizations.
Results visit, 30 minutes
In person or by video. What the results show, what they do not, the diagnosis or the next step, and the plan in writing.
Treatment and monitoring
Prescriptions, infusion scheduling, and the laboratory monitoring immunotherapy requires. You can message Dr. Ntranos between visits through the patient portal, and messages are answered within 1 business day.

If your symptoms need hospital care, we will tell you to go to an emergency department, and we can manage your treatment after discharge.

Clinical notebook beside an illustrative brain scan, laboratory tube and antibody symbol. — Antibody findings need to fit the rest of the neurological evaluation.

Treatment

Acute immunotherapy to stop the attack: high-dose corticosteroids, or infusion treatments that supply or remove antibodies. We prescribe and handle prior authorization. Infusions are given at an infusion center, not in our office.
Long-term immunotherapy to prevent relapse: an oral immunosuppressant or an infused antibody therapy, including the newer agents approved for specific conditions such as NMOSD and myasthenia gravis, monitored with regular blood work. The choice follows the diagnosis, and the condition pages go into the options.
Symptomatic treatment for seizures, spasticity, pain, sleep, and mood, rehabilitation by referral, and treatment of the underlying cancer with oncology in paraneoplastic syndromes. Where a clinical trial fits, we will say so.

Long-term follow-up

Most of these conditions need years of follow-up, which is where relapses are caught early and side effects are managed: 30-minute visits at an interval set by your condition, laboratory monitoring for immunosuppressant safety, repeat MRI when indicated, and forms for work and disability. Part of it is deciding, carefully, when treatment can be reduced.

When to seek an evaluation

Consider one if neurological symptoms came on over days to weeks with no clear cause, if new seizures came with memory or psychiatric change, if memory loss moved faster than a dementia would, if symptoms appeared alongside a known autoimmune disease or a cancer diagnosis, or if a positive neural antibody was left unexplained.

When not to wait for an appointment

Rapidly worsening confusion, a first seizure, sudden vision loss, or new weakness spreading over hours need emergency evaluation. Call 911 or go to the nearest emergency department. We are glad to take over afterwards.

When a label of dementia, epilepsy or psychiatric illness has never quite fit, the first visit goes back to how your symptoms began and changed. It is 60 minutes with Dr. Ntranos, in person in Beverly Hills or Los Angeles, or by video anywhere in California, and new patients are usually seen the same or next business day. Dr. Ntranos has 200+ five-star reviews on Google and Zocdoc. Follow-ups are usually every one to three months and last 30 minutes. Request a visit with no referral, and the office confirms your request within 1 business day. Visits are one flat fee with no facility charges, you receive a superbill, and most PPO plans reimburse 50–80%, depending on out-of-network benefits and deductible. See our billing page.

Autoimmune Neurology Evaluation in Los Angeles and Beverly Hills