Mrs. A -
The banding in each should have been compared.
Where your case is concerned (it was in blood serum and CSF) it would be moreso important to the neuro in the context of MS if "unique" banding were identified in the CSF. So, they would know the origin (blood, or CNS).
-shell
Lisa - the short answer to your question is that if you have no o-bands in your CSF it does not matter when, or if, they draw blood.
The downside to a non-existent/non-simultaneous blood draw is that if they do find o-bands in your CSF the information is of limited value. For full value they need to compare the results with blood drawn at the same time.
O-bands in CSF + O-bands in Blood = Non-MS indicator
O-bands in CSF + No O-bands in Blood = MS indicator
Hope this helps,
Kyle
I was told by my uncle who is a radiologist and physician in Italy that they only use the LP to rule out other diseases.
Even a negative LP for MS does not mean someone does not have MS, it is a bit hit and miss and many neuros do not like using this method as a diagnostic tool for MS only for other diseases which would definitely show positive on one.
I have met a few people over my time on forums who have had negative LPs but positive MRIS and been diagnosed with MS.
@Misty I think that, despite our desire for a black-and-white answer, the LP doesn't give one. It's just a piece of evidence that adds weight to one side of the scale or other. It isn't conclusive in-and-of-itself and it's meaning also depends on other factors. All other things being equal, no CSF o-bands point away from MS. However, some people dx'd with definite MS, (perhaps as many as 1 in 20), even with optimal testing, do not show o-bands. So no o-bands does not equal no MS.
"more than 95% of patients with multiple sclerosis (MS) have CSF OB of IgG class not detectable in serum" --> up to 5% don't
http://www.ncbi.nlm.nih.gov/pubmed/16945427
sho
I don't think that means no MS, misty, but I too have trouble wrapping my brain around it...I will have to draw out a flow chart to understand it! LOL
So, what my understanding is if you have no 0 bands in your blood or serum it is very possible you don't have Ms.
Is this correct?
Misty
when i had my LP they found inflammation in my blood as well, so the neuro told me even though there were lots of o bands in my csf there was inflammation in my blood but he didnt explain it. When I said to him could the inflammation in the blood just be a coincidence he said yes. So from what I have just read he was talking through the hole in his bottom lol.
The thing is Mr Neuro if I had O BANDS in my CFS (he said lots), and inflammation in my blood test and I dont have MS, then what do I have lol. They just leave us high and dry dont they.
Also i have to say. The LP was a walk in the park it did not hurt at all, HOWEVER, when he took the blood it was agony I nearly hit him. He made such a mess of it, the pain was horrendous and I nearly fainted. I have had loads of blood tests this was the worse even when I had one done by an old nurse who had retired and came at me with shaking hands she did a better job lol.
I thought the way you explained it was excellent. Thank you, but non the wiser lol.
Still in hell....ooops sorry no mans land. xx
Hi,
This is great, unfortunately when I went for LP I assumed the hospital KNEW what to do..I had an inconclusive LP because they never took blood when they did the LP....It was a wated LP, AND a lot of pain as I ended up in hospital with spinal headache.
rrrr
Jibs
To try to answer what I think is your question, from the point of view of MS if you have no o-bands in your CSF then it doesn't matter about the serum. However, as Lulu pointed out, you can't know that ahead of time so you should be sure they draw the blood. But if you had 0 CSF o-bands and they didn't take or lost your blood, there would be no point in a do-over for MS.
If you look at the chart in the health page, it tells you a little bit about the possible combinations of serum and CSF o-bands.
If the o-bands are only in the CSF or if there are unique ones in the CSF that aren't in the blood, this suggests that the inflammation is in the CNS and this is where the antibodies are being created.
If the same o-bands are in both the blood and the CSF, this suggests a systemic infection or antibody production that started in the body and crossed the blood-brain barrier into the CNS. This old article talks about people with neuro disorders and the same o-bands both in the CSF and the blood and found that "neoplasia and peripheral neuropathies accounted for over 50% of the diagnoses, infections and systemic inflammatory disorders for 32%, and multiple sclerosis was diagnosed in only one case."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1014760/
If the o-bands are only in the blood, that means that the antibodies are being generated in the body and not crossing the blood-brain barrier. There is a brief mention of possible dx's for oligoclonal bands in the blood starting on p 45 of this document:
http://www.bcsls.net/pages/documents/Moss-SerumProteinElectrophoresis.pdf
I hope somewhere in there is an answer to your question.
sho
Thank you for taking the time to respond to my question. I don't know why I'm unable to process this information.
If you're CSF is 0 in 0-bands, then what's the difference if your serum has any?
Yes, I'm having a stupid moment, unable to use abstract thinking processes. Sorry.
Lisa
Lisa, you would not know if there are UNIQUE o-bands in the CSF until AFTER the LP has been done. The comparison between CSF and Blood Serum banding is the key component to this test.
You can have zero bands in the CSF or 20 - that doesn't matter so much. What does make it significant is if the number in the CSF is different than the number in the serum. That is the only thing they are really looking at.
The sample needs to be done within the same time frame because our conditions can change - the head to head comparison of CSF and Blood Serum can only be done accurately if it is done in the same time.
I hope this helps.
Mary, this is a great synopsis. Thanks for taking the time to do this for everyone.
Lulu
Very well written Mary. Thank you for the information!
I know when my LP was done, the blood was used from the day before or two days before (so I was told by the laboratory).
My question is though, if no 0-bands exist in the CSF, why care what the serum has them or not or if it was drawn on the same day?