23) Oligoclonal bands may be present, but their presence varies when serially assessed.
24) Oligoclonal bands are uncommon and MRI abnormalities are non-specific.
Systemic Family history features Fever/night sweats, weight loss, arthropathy, rash, ulcers, dry mouth and eyes, ocular disease Neurological Persistent headache, fits, features encephalopathy, meningism, movement disorders, stroke-like events, peripheral neuropathy Investigations Raised ESR and/or CRP, serology; abnormal CXR Absent oligoclonal bands or persistent CSF pleocytosis Normal MRI or pronounced meningeal enhancement Table 2.
1) SPEP patterns Normal 20/l02 (19%) 71/228 (31%) Polyclonal gammopathy 52/l02 (51%) 42/228 (18%) Oligoclonal bands
34/l02 (33%) 31/227 (14%) Monoclonal gammopathy 8/l02 (8%) 37/228 (16%) (2.
Oligoclonal bands are not specific for MS and their presence must be considered in their clinical context.
In patients suspected of having MS, but without oligoclonal bands in CSF, alternative diagnoses should always be thoroughly investigated.
MRI and CSF oligoclonal bands after autologous hematopoietic stem cell transplantation in MS Neurology 2001; 56: 1084-1089
Link H, Huang YM, Oligoclonal bands in multiple sclerosis cerebrospinal fluid: An update on methodology and clinical usefulness.
Stendahl-Brodin L, Link H Optic neuritis: oligoclonal bands increase the risk of multiple sclerosis.
Tintore M, Rovira A, Rio J et al Do oligoclonal bands add information to MRI in first attacks of multiple sclerosis.
43) The overall sensitivity of MRI is nearly 90%, exceeding that of CT scans and CSF testing for oligoclonal bands.
5,47) In a 2-year follow-up study of 200 patients with suspected MS, 55 patients ultimately developed clinically definite disease; 84% of these 55 had an initial MRI strongly suggestive of MS, compared with CSF oligoclonal bands in 69%, abnormal evoked potentials in 69% and abnormal CT scans in 38%.