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Another alternative to oligoclonal bands for MS diagnosis is the MRZ-reaction (MRZR), a polyspecific antiviral immune response against the viruses of measles, rubella and zoster found in 1992. [22] In some reports the MRZR showed a lower sensitivity than OCB (70% vs. 100%), but a higher specificity (92% vs. 69%) for MS. [22]
Illustration depicting lumbar puncture (spinal tap) Spinal needles used in lumbar puncture Illustration depicting common positions for lumbar puncture procedure. The person is usually placed on their side (left more commonly than right). The patient bends the neck so the chin is close to the chest, hunches the back, and brings knees toward the ...
One drop of CSF sample (collected from the patient by lumbar puncture technique), is added to about 1ml of Pandy's solution. The turbid appearance signifies the presence of elevated levels of globulin protein in the CSF and is regarded as positive Pandy's reaction.
The test involves removing 30–50 ml of CSF through a lumbar puncture, after which motor and cognitive function is clinically reassessed. [1] The name "Fisher test" is after C. Miller Fisher , a Canadian neurologist working in Boston, Massachusetts, who described the test.
The presence of lymphocytic pleocytosis is generally detected through a lumbar puncture followed by clinical analysis of cerebrospinal fluid. When combined with analysis of the appearance and pressure of the tested CSF, along with measurements for the amount of glucose and proteins present, white blood cell counts can be used to detect or ...
Unusual types of MS have been described; these include Devic's disease, Balo concentric sclerosis, Schilder's diffuse sclerosis, and Marburg multiple sclerosis. There is debate on whether they are MS variants or different diseases. [31] Multiple sclerosis behaves differently in children, taking more time to reach the progressive stage. [5]
Given normal anatomy, the intracranial pressure will be reflected as a rapidly rising pressure measured from the lumbar needle, within 10–12 seconds. If there is a stenosis in the spine, there will be a damped, delayed response in the lumbar pressure, thus a positive Queckenstedt's maneuver.
For those children with spinal cord diseases, lumbar puncture may damage the spinal cord due to possibility of tethered spinal cord syndrome where the spinal cord is located below than the usual spinal termination level. [3] Therefore, lumbar puncture should be done at the lowest position as possible for such cases. However, spinal cord injury ...