CSF oligoclonal banding

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.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

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

References

Griggs 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.

Lublin FD, Miller AE. Multiple sclerosis and other inflammatory demyelinating diseases of the central nervous system. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Bradley: Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 58.

Review Date:4/30/2011

Reviewed by:Kevin 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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