Blood Tests

Dear Dr. Fong,
Could you please tell me in the United States where I can have blood work done for the following tests:

Anti MOG and Anti MBP  -  

I am very afraid of a spinal tap and my doctor told me that these tests would be approx. 95% proof of MS.

Where can I go and have the tests taken?

Thank you so much for your time.  

Kathy

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Multiple sclerosis is an inflammatory demyelinating disease that affects the central nervous system. To make the diagnosis there are specific criteria, in which objective neurologic findings are present affecting 2 or more locations in the nervous system in 2 or more episodes. In order to make this diagnosis, a detailed history and neurologic examination is required. MRI is very helpful and needed as it helps determining the presence of white matter lesions in 2 or more locations, however there are multiple conditions producing MRI changes that could be mistaken for MS, and the MRI should be reviewed properly and correlated to the symptoms. When the diagnosis is in doubt, a spinal tap (aka lumbar puncture) to study the CSF is helpful, and if there is still some doubt, there are other tests such as evoked potentials that can help. The key though is having two or more episodes in two or more locations of the brain.

The antibodies used in the workup of MS can be sent from most any hospital. If the question of MS is there, you do need a lumbar puncture. You will need to have oligoclonal bands, myelin basic protein, and IgG index performed in addition to the routine cell counts. If you have not done so, you also need an MRI of the brain with contrast.

I recommend that you follow up with a neurologist to ensure that your workup is complete and accurate.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.