LP Results and Neuro follow up----med. advice/info

I had my follow up with my neuro today.  

We ended up going through the MS Tracker step by step asking me about each and every symptom.  I explained each symptom and how I perceived it. She would ask “so you have problems with your bladder one day but not the next?”  “You might be weak one day and not the next?”   I told her it was a matter of intensity.  Sometimes I feel like I don’t even do my symptoms correctly!

We briefly touched on the opening pressure of my spinal tap which was 31.  She said if I don’t have headaches then it’s OK.  

We discussed the test results.  She showed me that the IGG synthesis was high as was the IGG Index.  She told me I have Oligiclonal bands in my spinal fluid but it’s also in my blood.  She said the tests can change over time.

I wonder if the fact that they forgot to take my blood on the same day of the LP impacted the results?  Basically, I have no clue what this stuff means but here it is:


IGG Index       .94          ref    0.00-.77
IGG Synthesis    3.41     ref   0.00-3.00

CSF contains oligoclonal bands.  Since the corresponding serum contains the same oligoclonal bands this is not specific enough to be supportive evidence of Multiple Sclerosis.  


She felt that I need to be seeing an MS specialist.  She said “I think you have MS but I want you to be seen at the University MS Clinic” So she referred me and also ordered new MRI.  

I feel good about the appointment.  She didn’t do an exam at all but did spend a lot of time with me.  I am not sure what to think  

So if this means I don’t have MS than why is she referring me?  Are O bands in blood and serum normal then?  Does the positive IGG stuff indicate something else?  

Thanks!

[Zacksmomi]

Hi there,
Sorry you do not have answers.  I wish I knew what it all meant, but I do know that when I had my LP done, 6 different people triple checked that I made sure to have my blood drawn THAT DAY and even the nurse wheeling me out to my car was insistant that if they did not draw on the same day that I would have to redo the LP.  

I do hope that you do not have to redo the LP and that the other results you have will be enough to get the answers you need.

Big hugs to you
D

[lovemy6monkeys]

Lois,

I was hoping to see an update from you today! I'm not sure exactly what the IGG stuff means. But, it sounds to me like based on your symptoms your doctor thinks there is a good chance of MS, but based on test results (current and former) there is not enough evidence to support a diagnosis?

I hope the MS Clinic can see you quickly and get those darn answers for you! Thank you for updating!

~Jess (who is supposed to be studying right now, so don't tell my kids that I'm taking a break LOL)

[tonyad]

    Here is some info for you to mull over  :)

CLINICAL UTILITY:
The ratio of a patient’s IgG and albumin in cerebrospinal fluid (CSF) to the IgG and albumin in serum is of diagnostic value in a number of neurological disorders. In normal CSF, the albumin and IgG are derived from the serum, whereas in patients with active multiple sclerosis (MS), the increased CSF IgG is believed to be synthesized within the CSF. The CSF Index is a calculated value which expresses numerically the ratio of IgG to albumin in CSF, to the ratio of IgG to albumin in serum. An elevated ratio suggests local CNS synthesis of IgG. An increased CSF/IgG Index is found in diseases such as MS, neurosyphilis, subacute sclerosing panencephalitis (SSPE), chronic CNS infections and CNS lupus erythematosus.

   I am sure someone will popon and give you better info. I was actually loking for an old thread on this that really explained it in a clear manner. I do not remember who wrote it and I can not find it..Sorry.

Take Care,
~Tonya

[RedFlame]

It is really confusing to me.

Jess, thanks for remembering!  It does seem to point that way regarding the need for more positive results.

Tonya,  It's good to see you, haven't seen you in a while.  Wow, the ratios and Igg stuff is really confusing to me---I am reading through it

[tonyad]

  Yes I agree....When you asked could the elevated results mean something else.....That's where I was trying to get to...Lol

    Here is the end of the paragraph.........
An increased CSF/IgG Index is found in diseases such as MS, neurosyphilis, subacute sclerosing panencephalitis (SSPE), chronic CNS infections and CNS lupus erythematosus.

    Oh ya, Are you saying that they did NOT do a blood draw from your arm the same day you had the LP?

~T
    

[RedFlame]

Yes, they forgot to draw blood the day I had the LP.  I recieved a phone call 4 days later asking me to come in to do a blood draw.  It probably didn't matter----I don't know.  

I have a hard time 'reading' my neurologist;  when she showed me the results--the High Igg index, and High Igg Synthesis rate I asked what that meant and she said "well, we are looking for Central Nervous System results.  So I don't know if she meant it was a positive sign for MS or a negative sign.  

I just read some of the health pages, it sounds like the Igg Index is all that matters.  My report doesn't say if the Igg index is from the csf or blood.  

I should have made her explain it better-----it just gets so daunting

[Zacksmomi]

Hi there,
Sorry you do not have answers.  I wish I knew what it all meant, but I do know that when I had my LP done, 6 different people triple checked that I made sure to have my blood drawn THAT DAY and even the nurse wheeling me out to my car was insistant that if they did not draw on the same day that I would have to redo the LP.  

I do hope that you do not have to redo the LP and that the other results you have will be enough to get the answers you need.

Big hugs to you
D

[RedFlame]

If I am reading correctly in the Health Pages---a high Igg index is a positive LP result.  
Maybe that's why she is referring me.

As far as the O-band thing----I really wonder if the blood issue tainted that whole part of the test.  

Thanks everyone!