The Role of Cerebrospinal Fluid (CSF) Analysis in Multiple Sclerosis (MS)
Why is CSF Testing Important in MS?
- MS is characterized by intrathecal synthesis of immunoglobulins.
- This is indicated by:
- Elevated CSF IgG index.
- Presence of CSF-specific oligoclonal bands (OCBs).
When is CSF Testing Most Useful?
- Not required for diagnosis in classic MS cases with typical MRI findings.
- Helpful in challenging cases, including:
- Clinically isolated syndrome (CIS) meeting radiologic criteria for dissemination in space but not time.
- CIS cases where MRI does not meet McDonald criteria for dissemination in space.
- Atypical MS presentations, including progressive onset.
- Cases where clinical, imaging, or lab features are atypical.
- Patients from populations where MS is uncommon (e.g., children, older adults).
- To increase diagnostic confidence, as OCBs are found in 95% of clinically definite MS cases.
CSF testing is valuable in confirming MS in ambiguous cases or when MRI findings are inconclusive.
CSF Oligoclonal Bands & IgG Index in MS Diagnosis
Oligoclonal Banding Patterns
- Types 2 & 3 indicate intrathecal immunoglobulin synthesis, which is highly suggestive of MS.
Test Name:
- IgG Index/CSF Oligoclonal Bands (Mnemonic: IGGIND).
Sample Requirements:
- Minimum volume:
- 310 µL CSF.
- 155 µL serum (0.3 mL blood).
Turnaround Time:
- 3 days from sample receipt.
CSF analysis significantly enhances the diagnostic certainty of MS in complex cases.
Contact Information
For more details or to arrange MS testing, contact:
- Ampath Customer Care: 012 678 1000
- Visit: ampath.co.za
CSF IgG index and oligoclonal bands improve MS diagnosis, particularly in early or atypical cases.