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lp results

Hi, I’m awaiting diagnosis, i have a question re lp and o bands result. My GP accessed the hospital results and told me “found o bands in serum only”. On asking what this meant she was a bit vague and said something like “you’ll be in the group of people without clear cut result”. I, wrongly probably, thought serum is csf, but on looking online realise serum is probably blood. On trying find how to interpret o bands i cannot find any reference to having result of o bands in serum only, only in csf only or none in either or o bands in both. . Please can anyone tell me what o bands in serum only means? I realise this test isn’t conclusive for Ms. Thanks, this limbo land doing my brain in. Seeing Ms specialist next Tues, hope things bit clearer, as I’ve had new symptoms and four days chronic fatigue, weakness, dizziness, vertigo alongside continual pins needles waist down over 3 months now, no let up. I’m pretty certain have MS and neuro tests see support this, dysfunctional optic nerve, nerve studies and exam abnormal, bladder/bowel issues, Myelitis, neuro seemed indicate this albiet vaguely, and referred me Ms neuro specialist. Any support be welcome, I’m quite low at moment. Gp has said i may not get all the answers next Tues, i am ready for this but maybe not ready get a diagnosis of Ms, is anyone ever ready? Jules

hi jules

if you have been referred to an ms specialist, it certainly sounds like you have ms to me.

the specialist should introduce you to your ms nurse and discuss DMDs with you.

it sounds like bad news but as limbo is such a sh*t place, it makes the bad news seem good!

look on the bright side, with a good DMD you should have fewer relapses and less accumulated disability.

hope you are reasonably happy with the result of your appointment.

carole x

ps let us know how you get on,

Thanks Carole, i swing between this is really scary to maybe its all a mistake and i will wake up back to usual self!! I’m not going to let it define me, whatever happens… I’m not sure how tell difference between symptoms ongoing and new relapse. Had nothing upper body until 3 weeks ago, now have regular numb tongue, face, arms, hands. Informed my Dr and he said just wait and tell at appt new symptoms. Yes, I’m hoping can get help but it’s all but full on. Trying keep stress down. Difficult. You’re v helpful, thanks yr response, how long you had Ms? Jules

Spinal Tap

A spinal tap (also known as a lumbar puncture) is a procedure whereby a sample of cerebrospinal fluid (CSF) is taken from close to the spinal cord. At the same time a blood sample is taken usually from the arm and a quantity of blood serum is isolated. Both of these samples are then processed using a technique called electrophoresis. A positive spinal tap will produce oligoclonal bands in the CSF but not in the blood serum. These bands indicate a type of immune system activity. Although uncomfortable, the spinal tap itself is often not too painful, whereas in the period following the tap, the patient may experience dizziness, nausea, vomiting and severe headaches, occasionally for as much as a week. There are a few rare but serious side-effects of spinal taps. For more information about spinal taps and how to reduce the possibility of some of the more unpleasant side-effects follow this link: Spinal Tap.

95% of people with a definite diagnosis of MS exhibit oligoclonal bands on a spinal tap. This may sound impressive but so do 90% of people with Sub-Acute Sclerosing Panencephalitis and 100% of people with Herpes Simplex Encephalitis among other conditions. Positive spinal taps are indicative of an immunological response but they are not diagnostic for a particular condition. That 5% of PwMS do not exhibit oligoclonal banding means that spinal taps neither rule-in nor rule-out MS.

The primary purpose of CSF analysis should be to rule out other conditions than multiple sclerosis. Although they can be highly suggestive of MS, they do not, in themselves, provide definitive disgnosis. Indeed, I myself, was given a definite diagnosis based on medical history, clinical examination, MRI and evoked potential tests - I declined to have a spinal tap.

Before MRI, electrophoresis of spinal fluid played a major role in supporting diagnoses and underpinned the Poser criteria. Now, however, these criteria have become overshadowed by MRI and, if an MRI is positive, the new diagnostic criteria (2001)allow for a definitive diagnosis without laboratory support. The old “Laboratory supported Definite MS” has been dispensed with.

However, CSF analysis technology is still advancing and researchers continue to look for definitive molecular markers of MS. Should they find such a marker, spinal taps will reassume their importance. Other researchers are looking into urine and blood for markers and we can hope that they are successful and spinal taps become completely unnecessary to the diagnosis of multiple sclerosis.

Hi, I’ve seen Ms neurologist this week. Not quite what i expected… My latest mri results weren’t back so he couldn’t really comment, altho the pictures he said were clearer with a white patch more visible on brain scan, but got wait report. He’s not diagnosed MS as wants rule out two other conditions which mimic Ms, espec as i presented with transverse myelitis and optic neuritis in May. So had blood tests now for Neuromylitis Optica, results 4-6 weeks! If test positive for NMO there is a clinic he will send me to, run by oxford john radcliffe hosp in November. So more limbo. Plus wants refer me to rheumatology to look at Sjogrens Syndrome as I’ve tested positive for auto immune condition with positive antibody RO. That could take months to sort out. But i feel all my symptoms fit with Ms. He’s given me Ms nurse details, so if any new symptoms or relapses can ring her, but it all feels so difficult and lonely when don’t know what is what! So glad got this forum. I think i thought, wrongly, that they had ruled out NMO when i was first in hosp with TM for a week in May. Certainly they talked about it. Feel bit let down that it’s taking so long, espec as NMO can be so destructive. I’m fed up, as symptomatic all the time but at least they being thorough i suppose. And on the question of O Bands, he gave me list of all abnormal tests and said O Bands showed up indicating Ms or something definitely wrong in CNS.

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I can empathise. I’m going through the same at the moment. Got a LP booked for Sept 12th. Not sure where I am with everything to be honest. My neurologist doesn’t seem to interested in my situation. I think because I’m not as severe as some but I’m currently having a bit of an episode which my GP thinks I need steroids for but won’t prescribe them because he doesn’t want to sqew my LP results. I’m at the point now where a diagnosis seems like a good thing. Not sure how that works! Either way, I try and stay positive but it’s certainly really hard at times when you feel so unwell. Hope you get more action soon.

Hi JoeyC, sounds like you are in limbo land too. If not had lp before, main advice is to lie down for as long as possible after the procedure. Some people swear by drinking lots of coke, not diet, before and after, as helps stave off headache which can happen. I got thru mine fine on lots of water but i was an inpatient so was able to stay flat for long time after. Results took a while but i hope you can get more supportive neuros. I did a brief diary like overview of symptoms, espec new ones since last saw him and gave them a copy. I also rang secretary when new symptoms stayed for a few days or more, and reported them. I got an earlier appt due to this. I hope you can get some clear help soon. I only got help after seeing 2 Drs who said i was anxious or had uti, then 3 a and e trips before being admitted with transverse myelitis and dysfunctional optic nerve. MS is difficult to diagnose and they need get right diagnosis as if it’s NMO then its different treatment. Let’s hope limbo land isn’t too long, but I’m learning live one day at time but keep “pushing” if don’t get help you know you need.