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Negative CSF Test Can You Still Have MS If Spinal Tap CSF Testing Comes Back Negative With No Bands ?

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Posted on Tue, 22 Nov 2022
Question: Hello I have been going through quite a bit of testing for ms symptoms. I had a mri come back for t2 flairs on white matter , swollen optic nerve more so on left side , weekness and tingling on left side and memory issues. I also had a csf test come back negative. Have also tested mildly positive for Ana testing since 2015. Can you still have MS if spinal tap CSF testing comes back negative with no bands ?
doctor
Answered by Dr. Dr. Erion Spaho (2 hours later)
Brief Answer:
Oligoclonal bands positive in 90% of cases.

Detailed Answer:
Hello,

I have read your question and understand your concerns.

No single test is definitely diagnostic for MS.

Lumbar puncture and subsequent evaluation for oligoclonal bands results approximately positive in 90% of cases. MS diagnosis is achieved by evaluation of the clinical findings. MRI findings, blood work ( to evaluate similar autoimmune diseases ), MRI findings, evoked potentials, and spinal tap.

I think, neuromyelitis optica should be included as a differential diagnosis in your case.



Take care.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Erion Spaho (19 hours later)
My vision is now 20/20 after 20 years of having to wear glasses. My peripheral vision on left side is horrible right now. This began with me seeing flashing lights on left side a few weeks ago and has continued. The numbness tingling and other issues began a few years ago and mri came up with no findings. Positive Ana and because of normal mri then my dr basically did no more research. Numbness and tingling over entire left side has not gone away but is definitely worse this past few weeks. Loosing balance , feel foggy , headache and eye pain also my left hand is not working right. Can not grip very tight and drop things. Memory has been horrible and feel exhausted. I do have a follow up with a specialist at Duke but would like to go in prepared and know what questions to ask. What else this may be. On top of everything else going on I ended up with a severe spinal headache after lumbar puncture and had a blood patch. Has been a scary few weeks. Please help.
doctor
Answered by Dr. Dr. Erion Spaho (2 hours later)
Brief Answer:
Read below.


In order to be correctly prepared for your follow up you need to write down your symptoms, their duration and intensity in time, all your tests and medications.

You may ask your Doctor:

-What's the most likely cause of my symptoms?

-What other tests do I need?

-Is my condition likely temporary or chronic?

-Is it possible that other conditions such other autoimmune diseases besides MS?

-Will my condition progress?

Hope this helps.

Greetings.

-What treatments are available?
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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Negative CSF Test Can You Still Have MS If Spinal Tap CSF Testing Comes Back Negative With No Bands ?

Brief Answer: Oligoclonal bands positive in 90% of cases. Detailed Answer: Hello, I have read your question and understand your concerns. No single test is definitely diagnostic for MS. Lumbar puncture and subsequent evaluation for oligoclonal bands results approximately positive in 90% of cases. MS diagnosis is achieved by evaluation of the clinical findings. MRI findings, blood work ( to evaluate similar autoimmune diseases ), MRI findings, evoked potentials, and spinal tap. I think, neuromyelitis optica should be included as a differential diagnosis in your case. Take care.