Have Chiari--Looking into MS as well...CSF prelim reults

[dkdean]

I do have a Chiari Malformation and symptoms from it.  On a routine MRI in November, a brain mass was noted and I had surgery on the temporal lobe to remove it in Dec 2010 (3 months post-op today!!!).  My CM symptoms have been increasing with great frequency and flaring.  My NS feels I am a candidate for decompression surgery, but wants to rule out MS as a contributing factor since I now have more and more brain lesions showing up on MRI's (and the symptoms b/t CM and MS can be so similar).  So, here's the preliminary results from the LP yesterday (still waiting on oligiclonal bands).  Thoughts???

Monos, Absolute: 0.5
Lymphs, Absolute: 2.2
Eos, Absolute: 0.0
Baso, Absolute: 0.0

IgG, CSF 1.40
Albumin, CSF 14.4
IgG Albumin Ratio .10
IgG, Serum 1130
Albumin, Serum 5110
Ratio, Serum 0.22
Index, CSF .45

Thoughts??

[COBOB]

The following are typical IgG Reference Ranges:

CSF index: 0.00-0.85
CSF IgG: 0.0-8.1 mg/dL
CSF albumin: 0.0-27.0 mg/dL
Serum IgG

0-4 months: 100-334 mg/dL
5-8 months: 164-588 mg/dL
9-14 months: 246-904 mg/dL
15-23 months: 313-1,170 mg/dL
2-3 years: 295-1,156 mg/dL
4-6 years: 386-1,470 mg/dL
7-9 years: 462-1,682 mg/dL
10-12 years: 503-1,719 mg/dL
13-15 years: 509-1,580 mg/dL
16-17 years: 487-1,327 mg/dL
> or =18 years: 767-1,590 mg/dL

Serum albumin: 3,200-4,800 mg/dL
CSF IgG/albumin: 0.00-0.21
Serum IgG/albumin: 0.0-0.4
CSF IgG synthesis rate: 0-12 mg/24 hours

In MS, a positive cerebrospinal fluid (CSF) finding would be:
1) Elevated IgG index
or
2) Two or more oligoclonal bands present in CSF that are not present in serum.

Bob

[dkdean]

Any insight with the above numbers???

[dkdean]

Thanks for responding...much appreciated!!!  I currently have 3 different neurosurgeons--all of whom are great at their areas of expertise--and have an appt with a NL who comes highly recommended--and also specializes in MS.  The symptoms are so similar between Chiari and MS, but the lesions and 'flares' I have (which I've always attributed it to Chiari) do seem to correspond more toward MS.  We shall see what it all shows.  I know the symptoms I have and how they effect me...I don't mind which name we give it, but I'd love to get appropriate treatment.  And, if I can go without another brain surgery, that would be nice!!!

[Sparkysarah]

This is a very technical question which many of us will be unanswer to answer.  When was your last MRI scan? I am sorry that you have had to have surgery recenlty and Christmas must have been a hard time for you recovering from major surgery.  I confess that I do not know anything about CM and I hope that you have a good neurologist who is able to look at all your symptoms, clinical history and MRI scans. You may want to look at our health pages on the top right hand side to see what is involved in the diagnosis of MS which involves the elimination of other conditions.

I hope that someone else is able to throw some insight into your results for you and look after yourself.

Sarah  

[dkdean]

More numbers:
Glucose,CSF:55
Protein, CSF: 29
WBC,CSF: 2
RBC,  CSF:3
Cellscounted: 100
Neutrophils,CSF:0
Lymphocytes,CSF: 74
Monocytes,CSF: 20
Macrophage,CSF: 6