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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: HIGH CSF PROTEIN CONSISTANT WITH CHIARI MALFORMATION?Forum: Neurology Forum
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Hi CCF, I first would like to thank you for all your help. I have now found a great group of doctors in my area for getting my neurological disease unknown etiology diagnosed. They are still looking at the possibility of MS. I have lesion on Optic nerve on right eye. But, Still have the underlying Arnold-Chiari Malformation type 1 with 6 mm herniation. My question to you is that recently discovered in doctor's note to primary explaining my High CSF Protein is Consistant with ACM. Could you explain this concept? I really don't understand they decide which is my problem MS or ACM. Is it possible that I have both diseases? I hear that ACM symptoms can be mistaken for MS. I have confidence that my new neurologist will beable to get to the bottom of solving my problems. Thanks Sincerely, Anneliese Dear Anneliese: Sorry to hear about your problem. Yes, there is the possibility of having an increased CSF protein in the presence of an Arnold Chiara type I malformation IF it was severe and there was blockage. I would doubt that a small 6mm type I lesion would induce a blockage and induce high protein in the CSF. Most of the small ACM type I do not cause symptoms at all, however, the ones that cause blockage and significant pressure defects and symptoms can. Yes it is possible to have both diseases. But there will be differences, in that there should be IgG synthesis in the CSF in MS. On the MRI there should be multiple (at least two) areas of demyelination. Both of these would be absent in ACM type I. In addition, there would be kappa chains in the CSF. I hope this helped you. Sincerely, CCF Neuro[P] MD
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