LP Results

[mathgirl24]

I'm going tomorrow morning to get results from my lumbar puncture.  I just hope that if it is MS, it shows up.  Limbo stinks!

[mathgirl24]

Nothing showed up.  So it's a watch and wait approach for now.  He did label it as CIS for now.  I'll repeat MRI in 6 months.

[supermum_ms]

Hey, I just got back from summer holidays over my side of the world....the LP isn't as necessary like it originally was with the Mcdonald criteria, the LP evidence can definitely be very useful additional suggestive-consistent diagnostic evidence though when your brain and or spinal cord MRI's doesn't meet the minimum Mcdonald criteria and now that the Mcdonald has been revised again, the LP evidence will again be taken into account for both MS and CIS.

"1 clinical attack (i.e. clinically isolated syndrome)
- with ≥2 lesions with objective clinical evidence
- with dissemination in time evident on MRI or demonstration of CSF-specific oligoclonal bands

1 clinical attack (i.e. clinically isolated syndrome)
- with 1 lesion with objective clinical evidence with dissemination in space evident on MRI
- with dissemination in time evident on MRI or demonstration of CSF-specific oligoclonal bands"

https://radiopaedia.org/articles/mcdonald-diagnostic-criteria-for-multiple-sclerosis-2017


"The revised criteria also revitalise the role of cerebrospinal fluid (CSF) analysis in diagnosing MS. In MS, it is very common to find antibodies in the CSF which show up as a characteristic banding pattern known as oligoclonal bands.With the widespread use of magnetic resonance imaging (MRI) scans in the diagnosis of MS, CSF analysis (also known as a spinal tap) has become less common.

With the 2017 revisions, oligoclonal bands can substitute for lesions to demonstrate dissemination in time in a person with the potential precursor to MS, known as clinically isolated syndrome (CIS), and who also meet the MRI criteria for dissemination in space

While oligoclonal bands are not unique to MS, they can support the diagnosis if clinical and MRI diagnostic features are not clear-cut. Equally the absence of oligoclonal bands does not rule out MS, but other CSF findings, such as increased protein concentration or the presence of certain cells, can suggest other diseases."
https://msra.org.au/news/refining-diagnosis-people-ms/

To be honest i'm really surprised your neurologist is willing to call it CIS with what your brain MRI showed and what you've mentioned happening to you...did he/her by any chance tell you the reason why he/she is thinking CIS above any other cause?

I am missing something to understand your dx of CIS, is it because of the neuro abnormalities that showed up in your neurological assessment?

Cheers.....JJ

[mathgirl24]

I actually went to see another neuro to get another opinion.  She is suspicious of MS and referred me to an MS specialist which I will see in June.  Until then I am getting a visual evoked potential test and an MRI of the T spine.  The new neuro noted brisk reflexes in my leg as well as some other issues on my neuro exam. I'm not sure why the other dr classified it as CIS other than I only have one lesion and the LP was normal.