Neuroimmunology & Autoimmune Neurology

Autoimmune disease can attack the nervous system at multiple levels—from the brain and spinal cord to autonomic pathways, peripheral nerves, neuromuscular structures, and interconnected neural networks. These disorders are often difficult to recognize because neurological, autonomic, rheumatological, vascular, endocrine, and inflammatory findings may appear disconnected.

Dr. Funk diagnoses complex neuroimmune and autoimmune neurological disorders including autoimmune POTS, autoimmune autonomic ganglionopathy (AAG), neuro-Sjögren’s, neurological manifestations of lupus (SLE), systemic sclerosis/scleroderma, antiphospholipid autoimmunity, autoimmune encephalitis and encephalopathy, autoimmune epilepsy, autoimmune cerebellar disorders and ataxia, autoimmune movement disorders, autoimmune small-fiber and peripheral neuropathies, inflammatory demyelinating neuropathies including chronic inflammatory demyelinating polyneuropathy (CIDP), multiple sclerosis (MS) and other central nervous system demyelinating disorders, transverse myelitis, neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), CNS vasculitis, paraneoplastic neurological syndromes, post-infectious neuroimmune disorders, and other forms of complex neuroautoimmunity.

Diagnosis requires more than finding an abnormal antibody. Dr. Funk integrates the patient's neurological phenotype with comprehensive neurological examination, advanced laboratory testing, neural and systemic autoimmune antibody profiles, inflammatory and immune markers, autonomic findings, neuroimaging, medical history, medications, infectious and post-infectious history, and other objective diagnostic information. He determines whether laboratory abnormalities fit the patient's clinical presentation and uses the complete pattern of findings to establish or refine the neurological diagnosis.

Dr. Funk then localizes the effects of neuroimmune disease throughout the nervous system. Depending on the condition, immune-mediated injury may affect specific cortical and subcortical regions, the limbic system, basal ganglia, cerebellum, brainstem, spinal cord, autonomic circuits, cranial nerves, nerve roots, peripheral nerves, small fibers, neuromuscular structures, or the neural pathways and interconnected networks linking these systems. This neurological localization helps determine how the autoimmune or inflammatory process is producing the patient's individual pattern of neurological symptoms and impairment.

A polysubspecialty approach is particularly important in neuroimmunology because autoimmune neurological disease frequently crosses traditional medical and neurological boundaries. Dr. Funk integrates Neuroimmunology with Dysautonomia, Neuromuscular Medicine and Peripheral Neuropathy, Movement Disorders, Seizures and Epilepsy, Vestibular Neurology, Neuro-Ophthalmology and Oculomotor Neurology, Vascular Neurology, Neuroendocrinology, Neuro-Infectious Disease, Neuroimaging, and other relevant neurological subspecialties to understand the patient's complete neurological and systemic presentation.

Dr. Funk also investigates mechanisms that may contribute to immune activation and neurological injury when clinically appropriate, including infectious and post-infectious processes, metabolic and endocrine abnormalities, nutritional factors, systemic inflammatory disease, vascular and endothelial mechanisms, medication effects, and other physiological contributors. This is particularly important in complex patients whose neurological symptoms may result from several interacting mechanisms rather than a single isolated autoimmune diagnosis.

Treatment follows the diagnosis, immune mechanism, and neurological localization. Rather than treating “autoimmunity” as a single diagnosis, Dr. Funk identifies the specific neuroimmune, neurological, biochemical, and physiological mechanisms relevant to each patient and develops an individualized strategy directed toward those findings.

Treatment may incorporate individualized neurological rehabilitation and neuromodulation, nutraceutical and over-the-counter medication strategies, and interventions directed toward modifiable metabolic, nutritional, inflammatory, and physiological factors when clinically appropriate. Neurological rehabilitation may incorporate vestibular and oculomotor rehabilitation, neuro-optometric rehabilitation, sensory and motor rehabilitation, peripheral nerve stimulation, transcutaneous auricular vagus nerve stimulation (taVNS), transcranial photobiomodulation, pulsed electromagnetic field therapy (PEMF), balance and coordination rehabilitation, and other targeted strategies according to the neurological systems involved.

When immunotherapy, disease-modifying therapy, prescription medication, rheumatological treatment, infectious-disease management, or other specialty medical treatment is indicated, Dr. Funk coordinates and co-manages care with the patient's prescribing clinicians and appropriate medical specialists.

The objective is not simply to identify an autoimmune marker or suppress neurological symptoms. Dr. Funk diagnoses the neuroimmune disease, determines how the immune process is affecting the nervous system, localizes the specific neurological structures, pathways, and networks involved, identifies modifiable mechanisms contributing to the patient's condition, and develops an individualized treatment and co-management strategy directed toward healing and ameliorating the patient's specific neuroimmune and neurological presentation.