Forum

Rizzo could you enlighten me on this please

Hi Karen you were away when I first posted this back 24 weeks ago, GOKr said you maybe able to help more back then but as I mentioned you were away.

This was results from my first LP, I did have another LP but was not told of these result in a letter but in hospital they did say there was more so it confirmed there is defo something going on.

My MRI showed a brain lesion which was explained as fuzzy so not a cancer or tuma which is solid, but as some sort of infection/inlamation, the LP showed 5 white cells, 92 red cells, protein 0.47 and glucose 3, white cells are all lympocyes and again could be consistant with imflamation. Oligocolnal bands were possitive with fewer bands in the serum than in CSF. ESR 4 and CRP less than .1 B12 normal, electrphoresis normal and ANA negative.

Your advice as always is appreciated.

I’ve never really studied blood test stuff so I’m not any good at it, sorry :frowning: There’s a danger with googling these too as different labs have different ways of doing tests so that the results may look normal/abnormal but actually be the opposite.

The positive oligoclonal bands result can support a diagnosis of MS, but it also happens in lots of other conditions and it’s possible to get a false positive. Fwiw, however, this lists the normal ranges of the CSF results: http://www.osceskills.com/e-learning/subjects/cerebrospinal-fluid-results-interpretation/ (please bear in mind the different labs thing though!).

From this, and assuming that the 92 red cells means 92 x 106 (which it might NOT!), it looks like it might point towards a subarachnoid haemorrhage. But then, wikipedia (not exactly a great source mind you!) suggests that 92 is too low for a subarachnoid haemorrhage. Another source (http://www.dartmouth.edu/~dons/part_1/chapter_11.html) says that a cerebral haemorrhage that leaks into the subarachnoid space can also cause red blood cells in the CSF. Would this maybe cause a lower red cell count than a subarachnoid haemorrhage???

A subarachnoid/cerebral haemorrhage MIGHT fit with the “fuzzy” lesion: MS lesions tend to have nice clean edges whereas strokes and vascular stuff often cause fuzzy edges, but I would hope the radiologist would have recognised a haemorrhage if there was one, and reported it as a possibility.

I also found this though: http://www.gpnotebook.co.uk/simplepage.cfm?ID=-1469382612. It says that subarachnoid haemorrhage can cause a positive oligoclonal bands result.

All of which probably only shows that using Dr Google is a dangerous path to tread - because it puts ideas in our heads that may subsequently prove to be complete rubbish!!! (Btw, apparently a subarachnoid haemorrhage starts with a sudden killer of a headache.)

Sorry, this is probably more confusing than helpful! It might be worth asking the neuro about the red cell count though? (It wouldn’t be high in MS I don’t think.)

Karen x

And just as I was about to click on post, it occurred to me that you might not know what subarachnoid/cerebral haemorrhages are. As far as I know, they are like a burst blood vessel. The arachnoid is one of the membranes / linings surrounding the brain. The subarachnoid space is the gap between the brain and the arachnoid. So a subarachnoid haemorrhage is a burst blood vessel in that space. A cerebral haemorrhage is a burst blood vessel in the brain.

Thank you Karen,

I tend to stear clear of Doctor Google as it does no good but thank you very much its a great help.

I wonder if the haemorrhage could cause my legs stop working and other symptoms I have but I suppose a little light reading couldnt hurt. Really apprciate it s always

x

Very useful links, My spinal fluid was a clear as water on both that they did so if Haemorrhage does show blood then its could be unlikely, all hypothetical of course, and these are the results from my first not second and the second was higher however she said it could changed up or down by 10% per test.

Just goes to show how complicated neurology is! It all seems so easy sometimes, but as soon as you get into the nitty gritty, you realise just how many variables and possibilities there are. We do complain about neuros a lot on here, but flippin’ 'eck, their job is hard!

Kx

Hi Tom . Sometimes when you get a LP done there is a certain amount of blood that can taint the CSF via the procedure. Looking at these levels I wouldn’t be concerned regarding RBC . Hope this helps . I am a biomedical scientist currently in limbo myself.

Welcome! We can certainly use your expertise around here :slight_smile:

Karen x

Thank you Karen and welcome and thank you Peter. On the first LP I had someone do it that made many mistakes and their was blood on the bed and my spinal fluid, I am 99% she had the tap turned on when inserting, and my second there was no blood on the bed or fluid so you may be right. Limbo sucks but again we are all hear to help each other and many thanks

It only takes a small amount of blood to raise the cell count . SAH would lead to a raised protein level which yours isn’t. I am waiting for my scans and LP also.

waiting for them or waiting for the result. the Scans are easy, the LP just make sure you get someone who knows what they are doing and you will be fine,

I’m waiting for them to be done. Concerned about the LP. It is something I have witnessed before and hoped it wouldn’t happen to me .

Ok well to start, its not as painful as it looks, As long as they et through the bottom of the nerves without nicking them its not too bad. you really cant feel much once they have numbed it. I thought it was them hitting bone which gave you a shock like hitting your funny bone but its no, I am sure you are aware but I will tell you anyway, they go through to the base of the spine because your nerves wrap round all the way down but at the bottom fray out meaning it will be less painful.

Having had two within 3 weeks I can tell you my second was much better once I knew what to expect and had someone do it that knew what they were doing. If youwant to know anything else just let me know.