Background Several neurological conditions are amenable to immunomodulatory therapy. Plasma exchange has been shown to be beneficial in a variety of neurological diseases. The use of plasma exchange has been increasing over the last few years.

Aim To ascertain the number of patients undergoing plasma exchange for neurological indications. To compare the clinical indications of plasma exchange to published guidelines.

To understand the clinical outcome of these patients and if possible compare with other immunomodulatory therapies.

Methods We retrospectively looked at data for all patients who underwent plasma exchange for neurological indications between 01 Aug 2010 and 31 Aug 2014 at the Queen Elizabeth Hospital Birmingham. 151 patients were included.

Results The age range of patients was between 19–86 years. Clinical indications included CIDP, MMN, Myasthenia Gravis, LEMS, NMO, MS, Limbic encephalitis, Stiff person Syndrome, GBS and other neuroinflammatory disorders. Around two thirds of the patients fell into categories I or II of the ASFA (American Society For Apheresis) guidelines. Around 60% of patients had a good response to plasma exchange with 70% of patients showing some improvement. A third of patients required some other form of immunosuppression.

Conclusion Our audit supports the use of Plasma exchange in neurological conditions with good outcomes including those conditions for which there is currently not much evidence.