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Definition

CSF oligoclonal banding is a test to look for inflammation-related proteins in the cerebrospinal fluid (CSF), the clear fluid that flows in the space surrounding the spinal cord and brain.

Oligoclonal bands are proteins called immunoglobulins, which suggest inflammation of the central nervous system. The presence of oligoclonal bands may be a sign of multiple sclerosis.

Alternative Names

Cerebrospinal fluid - immunofixation

How the test is performed

A sample of CSF is needed. A lumbar puncture (spinal tap) is the most common way to collect this sample. For information on this procedure, see the article on lumbar puncture.

Other methods for collecting CSF are rarely used, by may be recommended in some cases. They include:

  • Cisternal puncture
  • Ventricular puncture
  • Removal of CSF from a tube that is already in the CSF, such as a shunt or ventricular drain.

After the sample is taken, it is sent to a laboratory for evaluation.

How to prepare for the test

See: Lumbar puncture

How the test will feel

See: Lumbar puncture

Why the test is performed

This test helps support, but does not confirm, the diagnosis of multiple sclerosis(MS). The presence of oligoclonal bands in the CSF can also be seen in other illnesses.

Normal Values

Normally, one or no bands should be found in the CSF.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

There are two or more bandings found in the CSF and not in the blood. This may be a sign of multiple sclerosis or other inflammatory processes.

What the risks are

See: Lumbar puncture

ReferencesGriggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 418.
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CSF oligoclonal banding - series?

Normal anatomyThe cerebrospinal fluid (CSF) serves to supply nutrients to the central nervous system (CNS) and collect waste products, as well as provide lubrication.IndicationsWhy the test is performed:This test helps confirm the diagnosis of multiple sclerosis (MS).The laboratory procedure is called CSF electrophoresis, which is a method used to study the levels of protein in the cerebrospinal fluid (CSF).In electrophoresis, a CSF sample is applied to a gel (solid medium allowing the movement of proteins), and a voltage is applied. The proteins migrate along the gel based on their charge (roughly on their size). The gel is stained, and significant amounts of similar proteins will cause a visible "band" to be present. The term oligoclonal bands refers the presence in CSF of two or more protein bands of a specific immunoglobin (IgG) that have greater intensity than in the concurrent serum sample. This pattern of banding is seen in patients with MS, and other conditions.Procedure, part 1A sample of the CSF will be taken from the lumbar area of the spine. This is called a lumbar puncture. How the test will feel: The position used during lumbar puncture may be uncomfortable, but you must remain in the curled position to avoid moving the needle and possibly injuring the spinal cord. There also may be some discomfort with the needle prick and the insertion of the lumbar puncture needle. When the fluid is withdrawn, there may be a feeling of pressure.Risks of lumbar puncture include:Allergic reaction to the anesthetic.Discomfort during the test.Headache after the test.Bleeding into the spinal canal.Brain herniation (if performed on a patient with increased intracranial pressure), which can result in brain damage and/or death.Damage to the spinal cord (particularly ithe patient moves during the test).Procedure, part 2A blood sample will also be drawn.Procedure, part 3Both the samples are added to a gel, which is then filtered through a cartridge. The gel separates the proteins in each sample and the lab looks for oligoclonal banding.Results:Normal:One or less bandings found in the CSF is normal.Abnormal:Results are considered abnormal if there are 2 or more bandings found in the CSF and not in the blood serum. This may indicate multiple sclerosis (MS). CSF oligoclonal bands are found in 83% to 94% of patients with definite MS. Other causes of oligoclonal banding in CSF include encephalitis, meningitis, Guillain-Barre syndrome, polyneuritis, headache, and other conditions.Reviewed ByReview Date: 04/30/2011Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine;David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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