RT Journal Article
SR Electronic
T1 Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report.
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 897
OP 902
DO 10.1136/jnnp.57.8.897
VO 57
IS 8
A1 M Andersson
A1 J Alvarez-Cermeño
A1 G Bernardi
A1 I Cogato
A1 P Fredman
A1 J Frederiksen
A1 S Fredrikson
A1 P Gallo
A1 L M Grimaldi
A1 M Grønning
A1 G Keir
A1 K Lamers
A1 H Link
A1 A Magalhães
A1 A R Massaro
A1 S Öhman
A1 H Reiber
A1 L Rönnbäck
A1 M Schluep
A1 E Schuller
A1 C J M Sindic
A1 E J Thompson
A1 M Trojano
A1 U Wurster
YR 1994
UL http://jnnp.bmj.com/content/57/8/897.abstract
AB The Committee of the European Concerted Action for Multiple Sclerosis (Charcot Foundation) organised five workshops to discuss CSF analytical standards in the diagnosis of multiple sclerosis. This consensus report from 12 European countries summarises the results of those workshops. It is hoped that neurologists will confer with their colleagues in clinical chemistry to arrange the best possible local practice. The most sensitive method for the detection of oligoclonal immunoglobulin bands is isoelectric focusing. The same amounts of IgG in parallel CSF and serum samples are used and oligoclonal bands are revealed with IgG specific antibody staining. All laboratories performing isoelectric focusing should check their technique at least annually using “blind” standards for the five different CSF and serum patterns. Quantitative measurements of IgG production in the CNS are less sensitive than isoelectric focusing. The preferred method for detection of blood-CSF barrier dysfunction is the albumin quotient. The CSF albumin or total protein concentrations are less satisfactory. These results must be interpreted with reference to the age of the patient and the local method of determination. Cells should be counted. The normal value is no more than 4 cells/microliters. Among evolving optional tests, measurement of the combined local synthesis of antibodies against measles, rubella, and/or varicella zoster could represent a significant advance if it offers higher specificity (not sensitivity) for identifying chronic rather than acute inflammation. Other tests that may have useful correlations with clinical indices include those for oligoclonal free light chains, IgM, IgA, or myelin basic protein concentrations.