Question about lumbar puncure results...

[emmas1]

I have had intermittent numbness/tingling in hands, shoulder blade, left foot as well as balance issue, concentration issues, sensory issues, weakness in one hand for the past 6 months.  I've had mri's of brain, c-spine, t-spine, lumbar spine on a 1.5T that have all been normal.  Everything comes out normal.  My symptoms were at the worst probably in April and May and have gotten much better in the past 2 months.  I still have slight numbness/tingling that comes and goes but nothing as bad as it was.   I had my lp 2 months ago and was told my results are normal.  I got a copy of my lp results today and I found out something interesting but not sure what to make of it.  Glucose, protein, myelin basic protein, spinal fluid culture are all normal.

Here's what it says about Ogligoclonal Bands

"  The patient's CSF contains 2 well defined gamma restriction bands that are not present in the patient's corresponding serum sample.  These bands indicate abnormal synthesis of gammaglobulins in the central nervous system.  This finding is supportive evidence of multiple sclerosis, but should be interpreted in conjunction with all clinical and laboratory data pertaining to this patient.  The clinical significance of a numerical band count, determined by isoelectric focusing, and has not been definitely defined.  The data should be interpreted in conjuction with all pertinent clinical and laboratory data for this patient.

IS that NORMAL?  I'm not sure what to think...doesn't sound normal to me.  Did my neurologist make a mistake telling me my results are normal?  Help!

[emmas1]

Anyone?

[hbananas]

I was waiting for someone smarter to jump in, but here's my answer.  Any o-bands that are in the csf but not in the serum are not normal.  Some members have said their docs or labs counted one as normal, but not two, some even go up as high as four.

Not normal.  According to the quote you put in, the lab says it's not normal, too.  It's another mark on the "Yes, it's MS" side.  So either your doc is a two-band sort of  person, or they made a mistake.  Your proteins are normal, but not your OCBs.

With the normal MRIs, you're in a pickle.  You said your symptoms were bad, but have gotten better.  Have they ever gotten bad again?  Do they worsen with heat?

Have you ever had VEP or SSER (evoked potential) tests?

[Lulu54]

Hi Emmas,
The verdict is split on what the O-band count should be to say the evidence points to MS.  My neuro uses the standard of 2  or more distinct bands.  The Mayo clinic doctors and their followers look for 4 or more bands.  

Your report throws this all back to the clinical findings on your history and exam ....

Unfortunately it sounds like you are firmly stuck in limbo for now.  Enjoy feeling better and try to not dwell on this while you wait to see if other symptoms arise.  I'm so sorry that there were no answers for you right now.  When do you see your neuro again?

wishing you well,
Lulu

[sllowe]

  Hi there - welcome!

Yea, I think it was a mistake, because bare minimum you should have been told that the LP results indicated you were positive for O-bands. It's simply an untruth (or mistake) if you were told it's "normal."

Check out this health page for more info on O-bands:

http://www.medhelp.org/health_pages/Multiple%20Sclerosis/Can-you-Diagnose-MS-with-an-LP-that-is-Negative-for-O-bands/show/142?cid=36

MS is a clinical diagnosis and the Dr. would need more evidence - most use the McDonald Criteria (also in the health pages). I'm glad to hear that you are doing better than in months past, but with all the testing that was performed, it would be good to get all those results/reports lined up so you can bring them to someone else - especially if you get to feeling badly again and this Dr. is unwilling to look further into what could possibly be going on.

Thanks for joining us - see  you around,
shell