July 28, 2026

@michaelokun

One of the messages from Joe Jankovic's outstanding Aspen Movement Course lecture today on autoimmune-associated movement disorders that stuck with me was the importance of resisting the temptation to over-diagnose rare conditions. With the growing awareness of anti-IgLON5 disease, many of us have probably been ordering the antibody test more often than we should. Joe reminded us that testing is most appropriate when the clinical picture includes the characteristic sleep disorder, which remains one of the strongest clues to the diagnosis. He also shared an important case where the MRI showed abnormalities, underscoring that imaging can occasionally be helpful, although MRI is normal in most patients with IgLON5 disease. Perhaps he and Alberto Espay's most practical pearl was one we should all remember in clinic: if a patient looks like they have classic progressive supranuclear palsy (PSP), they probably have classic PSP, not IgLON5 disease. As new biomarkers emerge, thoughtful clinical judgment remains our most valuable diagnostic tool.