Received the full results of my Lumbar Puncture

[mj111169]

Hi all.  Everything is normal as far as protein and CSF Igg.  That is great news.  The only thing I am having trouble grasping is the fact that the CSF had "multiple restriction bands that are also present in the patients corresponding serum sample.  Unable to determine if they are of systemic or intracerebral origin"..........

I think that means normal, right?  However, shouldn't the lab have counted how many bands were in each the CSF and serum?  I'm just trying to figure this out.  

The neuro told me we might have to do a repeat lp sometime.  I really don't want to have to do that.  Also, he put me on blood pressure meds the last time I was there because my bp was elevated.  I went to my primary, and we monitored it for 2 weeks, and my bp is fine. (needless to say we didnt start the meds!)  I am just starting to question my neuro.  I was so happy with him when I first saw him, but the fact that he wanted me to start taking meds for something I didn't need makes me doubt my own judgment!  I have headaches sometimes, and he thought maybe it was from high blood pressure.  This was based on his 5 minute discussion with me at our last visit.  

Anyway, am I right?  Should the test have included the amount of obands found in csf vs. serum?  

Thanks.  TGIF!!!!!

Maureen

[mj111169]

Thanks for your replies!  I appreciate it.  

This board rocks as far as the information that is available from knowledgable people.  

Back to reality now, and I have decided to be positive about everything.  I won't complain about my commute, about how tired I am, etc.  I know I could be much worse than I am.

Maureen

[sllowe]

Hi Maureen,

Here is the HP on O-bands - it describes how the banding is compared.

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

It would be considered negative if the banding were identical (number, pattern, etc) in both the serum and CSF. They typically rule out the CNS as an origin if they find the same exact banding in the blood serum.  

If however, there were more in the CSF that were not seen in the blood it would be positive for O-bands.  

I cannot speak to the multiple restrictions. I don't know what that means or what it means for your health. I wish the neuro would have explained what that could mean. This should have been explained! And, I couldn't agree w/you more ref. your 2nd thoughts. The blood pressure and this are 2 distinct issues. And, 5 minutes is unacceptible!

-Shell

[COBOB]

Multiple restriction bands present in both CSF and Serum is a technical way of saying that there are "Unexpected gamma globulins bands in both serum and CSF."  They are not unique to the CSF.  The fact that the CSF IgG came back normal would seem to indicate that there is no active IgG synthesis.

The results could be read as "something has happened before that caused and immune response.  At this point, the bands are not unique to the CSF."  This test really doesn't rule out MS.  If the results showed restriction bands unique to the CSF, that would be considered to help support a diagnosis of MS.


Bob

[mj111169]

Thanks Kelly.  That is exactly what my primary said.  She was like "well maybe you had elevated bp because.....I don't know.....you are seeing a brain doctor for test results??"  I laughed.  And my primary did just that, went over my records.  She said it is slightly higher than when I started going there a couple years ago, but barely.  So is my weight, which I am working on.  

I go back to him in May.  (neuro)  He may schedule a repeat MRI at that time.  I guess I will just wait and see what happens at that time.  

Meantime, I have a killer headache today.  I am sure it is related to my period, because they have been coming on strong lately during the first couple days.  I did take my bp this morning to see if my headache had anything to do with my BP, and it was fine.  

Thanks again for your reply!

[anon07072023]

I'd have 2nd thought about repeating the LP, too.

I'm not exactly sure what restrictive bands are - if they're the same thing as o-bands?  If they are, it doesn't really sound like the report says whether or not you had more of them in your csf compared to your blood serum.  I had thought that if the restrictive bands were kind of high, then it points more towards MS. But then again, I really don't know.

I'm not sure why your neuro would have prescribed BP meds for you. You'd think that it might be something he could talk about with your primary doctor (if it was really high), and then your primary doctor could review your past records to see if you have a history of it that they didn't catch before. Your BP can be slightly elevated at any one time for a number or reasons (ie talking to your neuro about your results, etc  :-) ), and then it could go back down to normal.

-Kelly