Objective—To determine sensitivity and specificity of
western blot testing (WBT) of CSF and serum for diagnosis
of equine protozoal myeloencephalitis (EPM) in
horses with and without neurologic abnormalities.
Animals—65 horses with and 169 horses without
Procedure—CSF and serum from horses submitted
for necropsy were tested for Sarcocystis neuronaspecific
antibody with a WBT. Results of postmortem
examination were used as the gold standard against
which results of the WBT were compared.
Results—Sensitivity of WBT of CSF was 87% for horses
with and 88% for horses without neurologic abnormalities.
Specificity of WBT of CSF was 44% for horses
with and 60% for horses without neurologic abnormalities.
Regardless of whether horses did or did not have
neurologic abnormalities, sensitivity and specificity of
WBT of serum were not significantly different from values
for WBT of CSF. Ninety-four horses without EPM
had histologic evidence of slight CNS inflammation.
Conclusions and Clinical Relevance—The low
specificity of WBT of CSF indicated that it is inappropriate
to diagnose EPM on the basis of a positive test
result alone because of the possibility of false-positive
test results. The high sensitivity, however, means that
a negative result is useful in ruling out EPM. There was
no advantage in testing CSF versus serum in horses
without neurologic abnormalities. Slight CNS inflammation
was common in horses with and without S
neurona-specific antibodies in the CSF and should not
be considered an indication of CNS infection with S
neurona. (J Am Vet Med Assoc 2002;221:1007–1013)