Multiple sclerosis (MS): cerebrospinal fluid (CSF) analysis

Routine CSF indices

• The protein is normal in 70% of cases
• There is mild pleocytosis in 60% of cases 
• There are no neutrophils

Oligoclonal bands (OCBs): features

Oligoclonal bands (OCBs): patterns

Oligoclonal bands (OCBs): causes

Neurofilament light protein (N-LP)

Kappa free light chains (KFLC)

Osteopontin

Acronyms

References

1. McLean BN, Luxton RW, Thompson EJ. A study of immunoglobulin G in the cerebrospinal fluid of 1007 patients with suspected neurological disease using isoelectric focusing and the log IgG-index. Brain 1990; 113:1269-1289.
2. Dobson R, Ramagopalan S, Davis A, Giovannoni G. Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude. JNNP 2013; 84:909-914.
3. Zeman AZ, Kidd D, McLean BN, et al. A study of oligoclonal band negative multiple sclerosis. JNNP 1996; 60:27-30.
4. Mermelstein M, Naftali J, Wilf-Yarkoni A, Lotan I, Hellmann MA, Steiner I. Repeated lumbar puncture in search of oligoclonal bands - what is the yield? J Neurol Sci 2022; 439:120298.
5. Fenu G, Lorefice L, Sechi V, et al. Brain volume in early MS patients with and without IgG oligoclonal bands in CSF. Mult Scler Relat Disord 2018; 19:55-58.
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Related checklists

• Multiple sclerosis (MS): general investigations
• Multiple sclerosis (MS): magnetic resonance imaging (MRI): protocol
• Multiple sclerosis (MS): magnetic resonance imaging (MRI): features
• Multiple sclerosis (MS): inflammatory MRI differentials
• Multiple sclerosis (MS): other MRI differentials
• Multiple sclerosis (MS): ophthalmological tests