Cerebrospinal fluid examination by lumbar puncture

A mild pleocytosis (25 cells/mm3), mainly lymphocytes, is occasionally found. The total protein may be elevated, although this rarely exceeds 100 mg/1. An increase in gammaglobulin occurs in 50-60% of cases. Electrophoresis of CSF using agar or acrylamide shows discrete bands which are not present in serum.

These bands are found in up to 95% of patients with established disease and in 50-60% after the first attack. Oligoclonal bands are not specific to MS and can be found in other inflammatory neurological diseases (see following page).

OLIGOCLONAL BANDS

NORMAL

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