Lumbar punture results

[twist330]

I have recently had a lumbar punture - I have had a call from my consultant to say he had some of the results and these were normal, He has however not had microbiology results from the LP which he said included the white blood cell count. I was not in at the time he phoned and my husband took the call and made notes can anyone tell me if the OCB bands would be part of the microbiology results too of could this be what he has already received ?

[Quixotic1]

Hi, and I'm glad you PM's me to ask for a response.  I encourage anyone who wants a resposne from me, but hasn't gotten one, to send me a message or a note.

The results of the LP are sent all over the place.  The cell count usually goes to the Hematology section of the lab.  The Protein and Glucose go to Chemistry.  The gram stain (looking for bugs, fungi, and TB) and all the cultures go to Microbiology.  Some of the more odd tests like fungal stains and culture or the TB stain and culture may be sent out.  We all hope you don't have mushrooms in your CSF, tee hee.

Then there are the tests for Oligoclonal Bands and antibody production analysis (often called Immunoglobulin Synthesis).  The O-Bands are found with a combination of techniques called IsoElectric Focusing and Immunophoresis.  Not many labs are set up to do this here in the states and I suspect the same is true elsewhere.  These are often sent out.  

It is possible that your lab sends the O-Bands, IgG Index and all the Microbiology out to a reference lab.  In this case they might well come back together, once they are complete.  Typically, the cell count and the chemistry is done the same day in the same lab that does CBC's (Complete Cell Counts on the blood) and that runs Chem Panels.  Cell Counts have to be run immediately because the cells will degrade and dissolve if they don't.  Of course, that doesn't mean they are reported immediately.

My LP results from a major medical center took two weeks for all the different results  to come back.  I know it is longer in some places.  Many docs don't like to give out any of the results until they are all back.  To me, this makes sense, because they all need to be interpreted in the light of all the results.

For the fungal and TB cultures it takes several weeks.  They are slow growing.  Can people get TB and Fungal meningitis? Absolutely.  It's rare, but it does happen and it can cause all sorts of weird results.  However, there are always clues that something like that is amiss in the cell count and the protein and glucose levels levels.

So, the cell count was done immediately, but that doesn't mean the results have reached the Consultant or that he has enough results to discuss them intelligently with you.  BTW - my cell count was lost and my neuro was frosted!

Quix

[twist330]

Thanks twopack,
I think that answers my question. As it is a large teaching hospital I would expect everything to be done on site, and therefore I guess that the OCB are back and normal.
So I wonder what is going on in my body!

[twopack]

I believe microbiology and bacteriology look for disease causing organisms.  If that involves a culture it has to incubate for a designated minimum time even when nothing grows.  This department might also report WBC count (expect only a few).

I don't think the bands fit into this category of testing.  The fluid is usually sent to an outside lab as most places doing the LP can't run that specific test.  I'm not at all sure if it would take longer than other tests done by the same lab.

Mary

[twist330]

I just wondered still if anyone know's if OCB bands are part of mircobiology results? As the consultant has had the other results from the LP and they are normal.

[twist330]

Thank Deb61
I trying to stay "cool, calm, and collected" as I think if I rant he'll go "there you are your anxious " get my drift?

My only consolation is my Physio who I was seeing for and elbow injury as the symptoms started and has know me for years dosen't think it's anxiety either.

[Deb61]

I think your doctor is spewing out a bunch of bunk.  Why would he say it's anxiety when your brain MRI showed something and you've not had MS ruled out?  You obviously don't think it's anxiety after you put yourself through an LP.  This makes me mad, and I'm not even you!  

[twist330]

Thanks for sharing your experiences, I too had a very bad experience with the Lumbar puncture proceedure.

I do know that the brain stem potentails came back as normal. As did the EEG.

But it has been suggested that my symptoms of numbness in my limbs and part of my head could be anxiety although my first MRI showed a T2 Hyperintense focus in the right parietal subcortical white matter. This was done without contrast and I have to go back in a week to hvae an MRI with contrast.

So I'll have to wait and see. Thanks again for your advice.

[Deb61]

My o-band testing was sent off to Mayo.  It takes longer, generally, for these test results to come in.  My results were probably lost, and I will never know if I had o-bands. BTW, I've never heard anyone else complain that their results were lost--I'm probably the only person in the world that this has happened to.  

I've been diagnosed without the o-band testing results, and I had other evidence of MS.  I won't be going through that procedure again for no reason.

[Lulu54]

The final results on the o-band testing take longer than the rest of the LP tests, if I am remembering right.  It took about 3 weeks for all of my results to come back, and that was with the test for o-bands being done in-house by their expert.  

It is hard to be patient and wait, but unfortunately it sounds like you have to do that a bit longer.

be well,
Lulu

[HVAC]

It took over a month to get my results. They sent samples to 4 labs.

Alex