Proteins in fluid . Patients with ms often have a particular pattern of inflammatory markers in their cerebrospinal fluid. If ms is suspected but not proven, finding these proteins can help clinch the diagnosis.
It cannot by itself. Spinal fluid analysis is only one piece of the puzzle, and is not specific enough to stand alone to diagnose ms. Certain patterns are recognized in white cell count and certain proteins that identify an inflammatory state. In the right setting of clinical course, abnormal findings on the neurological exam, and usually specific MRI abnormalities, spinal fluid result will support the diagnosis.
Immunological. The lumbar puncture assesses presence of inflammation such as elevation of white blood cells, and increase of protein. A screen for infections is included, and cytological studies can evaluate occult cancers. But the diagnosis is supported if an elevation of oligoclonal bands or IgG of CNS origin. A myelin basic protein level may be elevated during an MS relapse. Spinal fluid can confirm.
Do you need it? I will do lumbar puncture in pts who are not convincingly diagnosed using MRI images, and who may have alternative diagnoses. If your MRI is diagnostic, you do not need an lp. But you should be starting a disease modifying agent asap. See a neurologist and get a plan in place. Supplement vitamin d-3. Read more...