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Multiple Sclerosis

It is important to remember that MS is only one part of a person and not the person.

MS does not represent them, it is not their identity, they are as normal as the next person.  

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Lumbar Puncture                                                                                                                                                                                        

Diagnostic test that involves removing and analysing a sample of cerebrospinal fluid - CSF, the fluid that surrounds the brain and spinal cord within the skull and backbone. A lumbar puncture takes about half an hour under a local anaesthetic. A hollow needle is inserted into the base of the spine and a quantity of cerebrospinal fluid is drawn off.

 

The overall discomfort experienced during a lumbar puncture itself is not great. However, the drop in pressure in the cerebrospinal fluid caused by the removal of a sample can produce a splitting headache. This usually lasts for no more than 24 hours but can persist for longer.

 

How does a lumbar puncture help diagnose MS?                                                                                                                                 

Analysis of cerebrospinal fluid in the diagnosis of MS is looking for:

White blood cells - the number of white cells in cerebrospinal fluid is usually up to seven times higher than normal in people with multiple sclerosis. If the count is even higher than this, it is probably due to an infection of some sort, such as Lyme's Disease and not MS.

 

Oligoclonal bands - the immune system produces antibodies to fight infection. In MS, it is thought that antibodies cross the blood-brain barrier and attack the myelin surrounding nerves. As a result, the level of antibodies in the cerebrospinal fluid of someone with MS is higher than it should be and is higher than the level in the blood, a sample of which is also analysed.

 

The test that shows the presence of antibodies is known as electrophoresis. A sample of fluid is placed on a gel and voltage is applied. This causes antibodies of the same size to bunch together, forming visible 'bands'.

 

One band - monoclonal - in the cerebrospinal fluid is normal.

 

Two or more bands - oligoclonal - shows the presence of disease activity. Whilst this doesn't necessarily mean that someone has MS, more than 80% of people with MS do have oligoclonal banding in their cerebrospinal fluid.

 

 

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