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abnormal spinal tap results
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abnormal spinal tap results

I had a spinal tap 3 weeks ago and my Dr was not able to specify what was going on with me. He has decided to order an MRI. But while I wait on that would like to hear some opinions on my levels from spinal tap.

Under cell count:
rbc fluid which was 18.

Under the test for ms:
IgG, syn rate, csf 25.7
Csf IgG index 2.3
IgG/alb ratio, csf 0.56

All other spinal fluid test came back normal.

Can you tell me what this means?
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Avatar_dr_f_tn
Hi there. If there is IgG detected intrathecally it points to multiple sclerosis. Your csf shows IgG levels so the neurologist is suspecting MS and needs an MRI brain to rule this out. The other positive finding in csf of MS patients are oligoclonal bands which are not affected by steroid therapy in MS. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Any association of muscle twitching with allergies cannot be commented upon. Therefore, it would be prudent to consult your neurologist with these concerns. Take care


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Avatar_f_tn
Thank you so much. I have had a range of auto immune symtoms (symptoms) over the past 2 1/2 years. Started with iritis, then to lost a patch of hair on my scalp. A biopsy was done and was dx with lichen planopilarus or alopecia (dx was not definite). Then severe pain in sacroliac or facet joints of my back. Ended up getting a medial branch block for that. After almost a year that pain stopped. But I continued to have severe stiffness from arthritis for about year. This was arthritis I had not had before. Ended up getting a medial branch block to reduce the pain. My inflammation levels my sed rates and c reactive protein went down to normal after a 2 1/2 years. Then had memory problems and problems sometimes understanding english. Had a pet scan that showed decreased activity in temporal lobes, and decreased uptake in cerabelum. So had the spinal tap. Any other suggestions of things to check into or do we have enough pieces to dx me yet. The waiting is hard and the constant going to dr. And it might be this or that.  I do appreciate the time you took to respond to me. I'm a sooooo grateful. Thank you!!!!
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