Letter sent to my Dr

Opened a letter this morning a copy of what’s been sent to my Drs. Will put everything from the letter. It says;

Just a note to advise you that Mrs Needham’s CSF showed 4 white cells, but with normal glucose, protein and tested positive for oligoclonal bands.

Cranial MRI scan showed a small area of altered signal in the right posterior frontal region which was not present on the previous study but with no evidence of enhancement to indicate disease activity. A further area of altered signal was noted envolving the central dorsal cord with evidence of enhancement indicating active demeylination.

He put about seeing me in clinic then will write to my dr with the outcome.

Any help to understand this will be a great help.

Hello Donna

Well, something like 80-95% of people with MS have Oligoclonal bands in their CSF (cerebrospinal fluid), but not in their blood serum, so I’d have expected the letter to say something about blood serum, but regardless, you do have O bands in CSF.

I think the bits about altered signal would be lesions of one type or another. Their specific place within the brain is important, but I’m lacking the knowledge to explain anything about that. The first bit of altered signal shows no enhancement so there’s no disease activity. And the second has enhancement showing active demyelination.

I reckon the doctor has pretty much diagnosed you already (I looked back at the post where he said you had ‘mild MS’. Therefore the MRI was backing up what he’d already thought. In particular, the active demyelination on the second area of altered signal probably means an active lesion, to my mind putting you in the relapsing remitting type of MS. The reason I think this is because my last letter about a recent MRI said there were 2 small enhancing lesions so in spite of having been diagnosed SP, my MS has become active again and therefore is Progressive Relapsing.

Obviously you could read through Rizzos post on how to demystify your MRI report at the top of this page, but it’s long and fairly technical. Or just wait for the appointment. Although I think you and I know what will be said at that appointment.

Your next challenge will be (hopefully) to think about which DMDs you would prefer to take. I assume you would a) be offered them, and b) decide the risks of side affects are worth the benefits in terms of relapse reduction.

You won’t have a completely free choice, but it’s worth knowing what the various options might be. You’ve probably already seen this, but have a look at MS Decisions aid | MS Trust

At least it’s not too long until your appointment.


No just under 2 weeks now. I’m getting the appointment report from my Drs this evening. (The appointment was on 2nd October)

Thank you for making me understand it abit better. I will have a look at the website you put up.

My husbands got critical care cover with work and MS is on it so we’re goin to print it off and take it to the appointment and show him and ask if we should apply for it and see what he says.