CSF

[Sue7]

I understand a finding of oligoclonal bands in the CSF serves as confirmation in approximately 90% of MS patients (the percentage seems to vary).  Does this mean that the bands will not appear in 10% of patients with MS, or does it completely rule out the diagnosis?  

[Quixotic1]

Hi, Actually the determination of O-Bands has improved in the last 3 years or so with the addition of IsoElectric Focusing to the blot or gel procedure, taking the percentage of patients of MS "at diagnosis" to as much as 96% (looking at the average results of several recent studies).  The finding cannot be taken alone to diagnose MS, but is a strong piece of evidence "toward" the diagnosis, when viewed with a good "clinical history and neuro exam" and with the MRI evidence.  It is also not clear that all labs ptesting for O-Bands are using this procedure, even though it is the recommended one for MS protocol on the CSF.

It is true that the earlier in the disease the more likely someone is to fall into the 1 in 25 which are negative for O-Bands.  And it is true that the number of O-bands tends to increase with duration of illness and with having the more inflammatory types of the disease (RRMS as opposed to PPMS).

I definitely agree with Dr_Shreekant that O-Bands alone do NOT make the diagnosis nor can it "confirm" the diagnosis of MS.  It lends weight to the suspicion of the disease.

If you are concerned about MS, you are invited to join us on the MS Forum.  

Quix, MD (Dx'd RRMS 03/07)

[Dr_shreekant]

The mere presence of oligo clonal bands (OCB) does not help in the diagnosis or ruling out of multiple sclerosis.Multiple sclerosis can be diagnosed based on certain clinical criteria which constantly undergo revision with time.
Let me quote a line from Harrisons principles of Internal Medicine, the Bible of Internal Medicine:
'Two or more OCBs are found in 75 to 90% of patients with MS. OCBs may be absent at the onset of MS, and in individual patients the number of bands present
may increase with time.'