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The Cerebrospinal Fluid in Multiple Sclerosis

Review article
Authors F. Deisenhammer
Henrik Zetterberg
B. Fitzner
U. K. Zettl
Published in Frontiers in Immunology
Volume 10
ISSN 1664-3224
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Language en
Links dx.doi.org/10.3389/fimmu.2019.00726
Keywords CSF (cerebrospinal fluid), biomarker, multiple sclerosis, oligoclonal band (OCB), neurofilament light, clinically isolated syndrome, intrathecal igm-synthesis, soluble, adhesion molecules, neurofilament light-chain, oligoclonal bands, disease-activity, axonal damage, natalizumab treatment, neuromyelitis-optica, diagnostic-criteria, Immunology, lman ch, 1987, journal of neurology, v234, p19
Subject categories Immunology

Abstract

Investigation of cerebrospinal fluid (CSF) in the diagnostic work-up in suspected multiple sclerosis (MS) patients has regained attention in the latest version of the diagnostic criteria due to its good diagnostic accuracy and increasing issues withmisdiagnosis ofMS based on over interpretation of neuroimaging results. The hallmark of MS-specific changes in CSF is the detection of oligoclonal bands (OCB) which occur in the vast majority of MS patients. Lack of OCB has a very high negative predictive value indicating a red flag during the diagnostic work-up, and alternative diagnoses should be considered in such patients. Additional molecules of CSF can help to support the diagnosis of MS, improve the differential diagnosis of MS subtypes and predict the course of the disease, thus selecting the optimal therapy for each patient.

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