CSF culture was negative; oligoclonal bands
showed a type 3 pattern.
The distinction between inflammatory and noninflammatory BCB dysfunction was based on the presence, in the latter group, of an isolated Qalb alteration in the absence of further pathological CSF changes, such as pleocytosis, oligoclonal bands
, or increased lactate concentrations (16).
Mild lymphocytic pleocytosis was noted in the CSF of 2 patients (cases 7 and 9), increased protein and IgG in 1 patient (case 4), oligoclonal bands
in one patient (case 9), and no abnormalities in another patient (case 5).
Spinal tapping was performed in four patients and IgG levels and oligoclonal bands
were examined in cerebrospinal fluid (CSF) samples.
In paediatric MS of early onset, the pattern of cerebrospinal fluid changes is different from that in older children and adults, with increased neutrophils and infrequently positive oligoclonal bands
To date, the reference method for the detection of oligoclonal bands
(OCBs) is isoelectric focusing (IEF) (5).
The CSF evaluation was normal with no oligoclonal bands
(OCB) and with normal IgG index.
12) CSF analysis may reveal moderate pleocytosis and a raised protein level, but only a minority have positive oligoclonal bands
Isoelectric focusing is the most sensitive method for detecting oligoclonal bands
(OCBs) (1), whereas agarose gel electrophoresis is reported to detect OCBs in -80% of cases (2).
Our case was diagnosed with clinical definite MS according to the McDonald's criteria (20) with clinically observed two attacks, lesions fulfilling the criteria of dissemination in time and space on MRI, and the abnormal VEPs and SEPs despite the absence of oligoclonal bands
in the CSF.
Modification of PhastSystem[TM] for the automated detection of oligoclonal bands
in native cerebrospinal fluid by IEF with immunodetection.
Cerebrospinal fluid examination for the presence of oligoclonal bands
was also normal.