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Confused about oligoclonal bands

Hi Everyone,

I have been to the doctors today and apparently my Oligoclonald bands are the same in my blood as csf fluid which apparently makes it unlikely to be ms.

I don't understand what this means or what else could be wrong, all I know is that I am feeling really poorly and with ms symptoms.

LIsa x

Oligoclonal bands are a type of protein that is produced by the immune system so the sample they are found in can show where the immune system has been active. Bands in CSF mean that the immune system has been active in the central nervous system (CNS) and bands in serum mean that the immune system has been active in the rest of the body. (Serum is the liquid left after blood coagulates.)

When you have a lumbar puncture, they take a blood sample at the same time and then test both the CSF and the serum from the blood. Bands that are in one sample, but not in the other are called "unmatching". Results might be no bands in either sample, bands in only one sample, matching bands in both samples, or bands in both samples, but more unmatched bands in one of them.

Someone who has matching bands in CSF and serum is thought to have a "systemic" cause of their symptoms, in other words, something wrong with them that has affected everything: their body and their CNS. This is called a Type 4 result. (And it sounds like this is what your test shows.)

Because MS only involves an immune response in the CNS, the most typical LP result is unmatched bands in the CSF (so those bands are not in the serum). This is called a Type 2 result. 

Note that I've only said "most likely" and "most typical" - this is because LP results are not definitive and you can get people with MS who have Type 2, Type 4 and even normal results. LP's are merely one piece of the puzzle. 

There are many systemic diseases, including lupus, rheumatoid arthritis and some infections. Some of these can cause symptoms that are very similar to MS.

Hopefully your neuro will be able to work it out for you.

Karen x

Hi Karen, Thank you for your reply, I understand it much better now. You really are such a star and I don't know what this board would do without you and many other people here. Thanks again Karen, I will post on here after my neuro appointment next month. Lisa xxx

Hi Lisa, yes, our Karen is a star for helping us sift through medi speak!

I never knew what LP results meant......except that the 2 I`ve had were `normal`. So i am clearer on it now too.

luv Pollx

Hi Karen I am confused and need advice. I was diagnosed 4 months ago with Demyelination as there was inflammation on my cerebellum. I have had a second MRI last week and have received a letter from the Neurologist. It stated no new lesions present and the abnormality is slightly smaller. He also states that oligoclinal bands were positive in serum and csf with additional bands in the car indicating intratgecal synthesis. I do feel pretty good and there is improvement but would appreciate if you could explain what this means? Sally x
I have MS

Hi Sally

The post you are replying to is very old, the last reply being in 2013. Karen (Rizzo) no longer replies to posts on the forum. 

You would be better off starting a new thread by hitting the New Thread button, you give it a title, write what you want to know / communicate, and hope that someone else is knowledgeable enough to answer. 

Sadly I am not. 

Sue

Anonymous

Spinal Tap

A spinal tap (also known as a lumbar puncture) is a procedure whereby a sample of cerebrospinal fluid (CSF) is taken from close to the spinal cord. At the same time a blood sample is taken usually from the arm and a quantity of  blood serum is isolated. Both of these samples are then processed using a technique called electrophoresis. A positive spinal tap will produce oligoclonal bands in the CSF but not in the blood serum. These bands indicate a type of immune system activity. Although uncomfortable, the spinal tap itself is often not too painful, whereas in the period following the tap, the patient may experience dizziness, nausea, vomiting and severe headaches, occasionally for as much as a week. There are a few rare but serious side-effects of spinal taps. For more information about spinal taps and how to reduce the possibility of some of the more unpleasant side-effects follow this link: Spinal Tap.

95% of people with a definite diagnosis of MS exhibit oligoclonal bands on a spinal tap. This may sound impressive but so do 90% of people with Sub-Acute Sclerosing Panencephalitis and 100% of people with Herpes Simplex Encephalitis among other conditions. Positive spinal taps are indicative of an immunological response but they are not diagnostic for a particular condition. That 5% of PwMS do not exhibit oligoclonal banding means that spinal taps neither rule-in nor rule-out MS.

The primary purpose of CSF analysis should be to rule out other conditions than multiple sclerosis. Although they can be highly suggestive of MS, they do not, in themselves, provide definitive disgnosis. Indeed, I myself, was given a definite diagnosis based on medical history, clinical examination, MRI and evoked potential tests - I declined to have a spinal tap.

Before MRI, electrophoresis of spinal fluid played a major role in supporting diagnoses and underpinned the Poser criteria. Now, however, these criteria have become overshadowed by MRI and, if an MRI is positive, the new diagnostic criteria (2001)allow for a definitive diagnosis without laboratory support. The old "Laboratory supported Definite MS" has been dispensed with.

However, CSF analysis technology is still advancing and researchers continue to look for definitive molecular markers of MS. Should they find such a marker, spinal taps will reassume their importance. Other researchers are looking into urine and blood for markers and we can hope that they are successful and spinal taps become completely unnecessary to the diagnosis of multiple sclerosis.