CSF cell count (per mm3) * 26 ([+ or -] 12) Lymphocytes (%) * 92 ([+ or -] 8.0) Protein (mg/dl) * 60.4 ([+ or -] 19.2) Oligoclonal bands
positivity 29 (42%) AQP4 positivity 1 (1%) CSF: cerebrospinal fluid; MS: multiple sclerosis; mm3: cubic millimetre; mg-dl: milligram per deciliter.
Laboratory findings include CSF pleocytosis, oligoclonal bands
, and detection of anti-NMDA receptor antibodies.
Males CIS RRMS N 21 14 Duration, months 1.7 [+ or -] 2.6 56.8 [+ or -] 47.4 EDSS score 1.6 [+ or -] 1.2 2.3 [+ or -] 1.1 Smoking, no/yes 10/11 4/10 Relapse, no/yes 7/14 6/8 OB, no/yes 7/14 3/11 GEL, no/yes 11/10 7/7 Inactive/active 5/16 4/10 Females CIS RRMS N 32 22 Duration, months 3.9 [+ or -] 13.1 45.1 [+ or -] 46.8 EDSS score 1.4 [+ or -] 1.1 1.7 [+ or -] 1.1 Smoking, no/yes 18/14 13/9 Relapse, no/yes 13/19 9/13 OB, no/yes 9/23 5/17 GEL, no/yes 16/16 5/17 Inactive/active 8/24 4/18 OB: oligoclonal bands
in CSF; GEL: gadolinium enhanced lesions in MRI; inactive: patients in remission without GEL in MRI; active: patients in relapse or with GEL in MRI.
The likelihood of progressing from CIS to MS is directly related to the presence of CSF oligoclonal bands
(OCB), motor symptoms, and finding of high numbers of MRI white matter lesions.
CSF-specific oligoclonal bands
(OCB) were determined by isoelectric focusing in polyacrylamide gels with consecutive silver staining.
Usually the diagnosis of demyelinating disease is supported by the presence of lesions involving the periventricular and corpus callosumareas and the detection of oligoclonal bands
from cephalospinal fluid [33, 34].
Using fluid from the lumbar puncture, spinal fluid, we are able to search for specific indicators, including oligoclonal bands
, white blood cell count, total protein, and IgG index, that have been associated with MS and other inflammatory diseases.
(1) In 2010, the College of American Pathologists (CAP) began offering a new proficiency survey on oligoclonal bands
, OLI, which includes paired CSF and serum samples for laboratories performing these assays.
A lumbar puncture showed elevated protein and oligoclonal bands
. CT scans of the chest, abdomen, and pelvis were unremarkable.
Cerebrospinal fluid examination showed no oligoclonal bands
and magnetic resonance imaging of the spine was normal.
CSF examination was again undertaken and was positive for oligoclonal bands
. Repeat testing with the MMSE gave a score of 22/30.