matching oligoclonal bands in csf and serum

In addition, the serum bands in systemic inflammation tend to be small and evenly distributed (3). CSF oligoclonal banding is a test ordered by physicians when serious health concerns related to your central nervous system arise. An official website of the United States government. However, medical risks exist, including: People usually have discomfort during and shortly after the test. This site needs JavaScript to work properly. The presence of oligoclonal bands in CSF from patients with multiple sclerosis does not correlate with the activity of the demyelinating process. 2023 Mar 14;100(11):e1095-e1108. Dr. Greenlee has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Sommers Schwartz. If you are responding to a comment that was written about an article you originally authored: People who receive a diagnosis of MS typically have positive test results, indicating that OCB is present in the CSF. Dizziness, light headed for 4 weeks. The complex relationship between oligoclonal bands, lymphocytes in the cerebrospinal fluid, and immunoglobulin G antibodies in multiple sclerosis: Indication of serum contribution. WebOligoclonal bands (OCBs) are bands of immunoglobulins that are seen when a patients blood serum, or cerebrospinal fluid (CSF) is analyzed. Dr. Greenlee has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Wheeler, Trigg, O'Donnell, LLP. J Neurol Neurosurg Psychiatry. The separated immunoglobulins (Ig) are visualized by an IgG immunoblot, and OCBs that are present in the CSF and not in the serum are reported. Lancet Neurol. Typically, Botox is used to reduce the appearance of facial wrinkles. The CSF oligoclonal band screen looks for these bands in your CSF. BMJ Case Rep. 2020 May 27;13(5):e234316. What is the interpretation for this sample? These bands in the CSF pattern are produced by a limited number of immunocompetent cell clones, each producing IgG with its own specificity. The results of an EEG can be used to rule out or confirm. The presence of more than one band is an indicator of illness. To detect OCB levels, a doctor may order a CSF oligoclonal banding test, which requires a sample of the CSF. Similarly, if a test comes back negative but a person is experiencing symptoms, additional tests may be necessary to confirm what is causing the symptoms. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Unconcentrated CSF and diluted serum are electrophoresed by isoelectric focusing. The institution of an immediate family member of Dr. Liu has received research support from NIH. 13 The presence of two or more OCB in the CSF without an identical match in the serum is considered pathological. In some cases, additional time should be The separated immunoglobulins (Ig) are visualized by an IgG immunoblot, and OCBs that are present in the CSF and not in the serum are reported. SI Abnormal Reports. 2012 Apr;44(3):248-50. doi: 10.1097/PAT.0b013e3283511a87. Bethesda, MD 20894, Web Policies official website and that any information you provide is encrypted They will clean the skin and numb the area using a local anesthetic. 2023 Healthline Media LLC. The purpose of this test is to determine whether or not there are immunoglobulin proteins called oligoclonal bands dwelling in your cerebrospinal fluid. Lane 1, serum sample; lane 1, corresponding CSF sample. National Library of Medicine A persons healthcare team should make them aware of any additional steps they should take to prepare for the test. When the oligoclonal band assay detects 2 or more unique IgG bands in the cerebrospinal fluid (CSF), the result is positive. CSF free light chain identification of demyelinating disease: comparison with oligoclonal banding and other CSF indexes. Clin Chem Lab Med. The procedure usually takes about half an hour. Oligoclonal bands present in CSF, but not in serum, indicate central nervous system production. OMG, you are so describing me. Have you found anything out yet? I've been dealing with this now for 2 years with no answers and countless tests. The institution of Dr. Paz Soldan has received research support from National Institutes of Health. Thompson AJ, Banwell BL, Barkhof F, et al: Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Fortini AS, Sanders EL, Weinshenker BG, Katzmann JA. (2007). Previously considered an incidental finding, some patients have matched IgG bands present in both the CSF and serum. Those with matched oligoclonal bands only were more likely to be older (p<0.001) and to have systemic autoimmune disease (p 0.004). Elsevier; 2015:chap 18). Correale, J., & de los Milagros Bassani Molinas, M. (2002). Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment. The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life, Acute Migraines Relieved By Beta Blocker Eye Drops, Alzheimer's Disease: Current Concepts & Future Directions, Causes of Headaches and Treatment for Headache Pain, New Gene Discoveries Shed Light on Alzheimer's. Some of the risks for spinal taps include: To minimize the risk of negative reactions, be sure to follow your doctors advice on fluids and foods, and inform them of any allergies to medications., In order to perform the CSF Oligoclonal Banding test, a sample of your cerebrospinal fluid is retrieved. Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Clear diagnoses had been made in 112 of these patients: in 56 identical CSF and serum bands were present, revealing a systemic immune response, while in 46 additional unique CSF bands indicated that intrathecal IgG synthesis was also occurring. Typical example: MS. Unconcentrated CSF and diluted serum are electrophoresed by isoelectric focusing. Multiple sclerosis (MS) is a progressive condition that affects the central nervous system and the brain. B. Epub 2022 Mar 11. I have had severe dizziness since August of 2009. The Motor Evoked Potential (MEP) Test Explained, Overview of Chemodenervation (Non-Cosmetic Botox Injections), The Rise and Fall of the Controversial Doctor Behind Deep Brain Stimulation, Electric Current to the Noggin Improves Memory, Is the COVID-19 Vaccine Linked to Tinnitus? An official website of the United States government. All rights reserved. Routine CSF examination includes measuring oligoclonal bands (OCB) status, IgG index, albumin ratio, and cell counts. Careers. Diagnosis of multiple sclerosis; especially useful in patients with, Clients without access to Test Prices can contact, Prospective clients should contact their Regional Manager. Type 2 (C + S): Oligoclonal IgG is present in the CSF with no apparent corresponding abnormality in serum, indicating local intrathecal synthesis of IgG. WebEvaluation of these oligoclonal bands have centred on disease-specific conditions such as multiple sclerosis and a range of inflammatory conditions, often emphasizing the intrathecal production. Heres what you need to know about it. ways to boost your brainpower. Type 3 (C + > S+): There are IgG bands in both the CSF and serum, with additional bands present in the CSF. 2003 Nov:120(5):672-675, 3. FOIA During the procedure, a person will lie on their side with their legs pulled up toward their chin and their chin tucked in. We offer this Site AS IS and without any warranties. The significance of serum oligoclonal bands in neurological diseases. However, the target specificities of the IgG in MS OCBs have remained undiscovered. A doctor may use a CSF oligoclonal banding test to help confirm MS, but they will also need to consider other diagnostic criteria. 2018 Feb;17(2):162-173, 4. CSF is the clear fluid that is present around the spinal cord and the brain. Isoelectric focusing with the IgG immunoblotting compared with high resolution agarose gel electrophoresis and cerebrospinal fluid IgG index. Doctors can use this screen to help them diagnose MS. Clinical charts were reviewed by a neuroimmunologist. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2022 May;52(3):511-525. 5 Less has been reported on the other patterns and their relevance in the wider range of CNS disorders. If they find that a person has MS, they will work with the individual to develop a treatment plan based on their particular needs. Finally, in an adjusted logistic regression fit to death, there was a significant decrease in odds of death for those with matched plus unique oligoclonal bands compared to those with only matched bands (OR 0.52 [95% CI 0.29 0.94]). Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. WebCSF is used in the diagnosis of multiple sclerosis (MS) by identifying increased intrathecal IgG synthesis qualitatively (oligoclonal bands). Significance of Myelin Oligodendrocyte Glycoprotein Antibodies in CSF: A Retrospective Multicenter Study. Could a little jolt of electricity to the outside of your head improve your brain function? A doctor may use a CSF oligoclonal banding test to help confirm a diagnosis of MS. Didn't find the answer you were looking for? How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Multiple Sclerosis Association of America, https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-Tools/Cerebrospinal-Fluid-(CSF), https://www.frontiersin.org/articles/10.3389/fimmu.2019.00726/full, https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-MS, https://www.nhs.uk/conditions/lumbar-puncture/, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-puncture, New clues to slow aging? The results can help diagnose conditions of the central nervous. However, they should let the doctor know about any medications they are taking, including blood thinners, and any medical history that relates to their spine. Andersson M, Alvarez-Cermeno J, Bernardi G, et al: Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report. O'S-ci + *, only" (symbolised in the figure by a *); 3) patientswithatleast onecloneinserumandat least one clone unique to CSF, have both intrathecal andsystemic In: Burtis CA, Bruns DE, eds. In addition, serum oligoclonal bands are present in some patients with Hodgkin's disease and in up to 5% of normal individuals. Lancet Neurol. Your doctor may suggest you take a mild pain reliever. The https:// ensures that you are connecting to the IgG oligoclonal bands (OCBs) are present in the cerebrospinal fluid (CSF) of more than 95% of patients with multiple sclerosis (MS), and are considered to be the immunological hallmark of disease. Results: We identified 502 patients with matched oligoclonal bands and 117 patients with matched plus unique oligoclonal bands. Anecdotal reports are surfacing that some people are developing tinnitus days after receiving one of the COVID vaccines. Oligoclonal bands and antibody responses in multiple sclerosis. PMC Your doctor will read them and discuss the next steps. In the first group neoplasia and peripheral neuropathies accounted for over 50% of the diagnoses, infections and systemic inflammatory disorders for 32%, and multiple sclerosis was diagnosed in only one case. sharing sensitive information, make sure youre on a federal All rights reserved. 7th ed. Search for other works by this author on: Multiple cerebrospinal fluid bands: multiple sclerosis? For more information see: -OLIG / Oligoclonal Banding, Serum and Spinal Fluid, -MSP3 / Multiple Sclerosis (MS) Profile, Serum and Spinal Fluid, Isoelectric Focusing (IEF) with IgG Immunoblot Detection. Dr. Rose has received intellectual property interests from a discovery or technology relating to health care. However, as the National Multiple Sclerosis Foundation states, test scores are not enough to confirm a diagnosis. This site needs JavaScript to work properly. What should I do? The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Northwestern University researchers think so. What is the differential diagnosis for multiple bands in CSF with some accompanying bands in serum? It is good laboratory practice to perform oligoclonal banding analysis with parallel cerebrospinal fluid (CSF) and serum samples. Clients without access to Test Prices can contact, Prospective clients should contact their Regional Manager. New to this community of sorts and want to pose a question I know has been asked similarly on some other threads. Mult Scler J Exp Transl Clin. This test is not specific for multiple sclerosis. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The test is also known as CSF oligoclonal banding or CSF immunofixation. The reason for this is that the presence of OCBs can also indicate other conditions that cause inflammation in the CNS. IgG in normal CSF migrates as a faint diffuse zone, but in demyelinating diseases, IgG migrates as discrete oligoclonal bands. WebCSF is used in the diagnosis of multiple sclerosis (MS) by identifying increased intrathecal IgG synthesis qualitatively (oligoclonal bands). None found; four or more CSF-specific bands have been shown to be most consistent with MS. Two of the largest studies on Alzheimers have yielded new clues about the disease, The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. This gown gives the person conducting the test easy access to your spine. 2003:120:672-675, 3. A. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. PMC The detection of increased intrathecal immunoglobulin synthesis is the basis for current diagnostic laboratory tests for MS. The institution of Dr. Paz Soldan has received research support from Novartis. The institution of Dr. Clardy has received personal compensation in the range of $0-$499 for serving as a Consultant for Genentech. Youll need to change into a hospital gown with the back open. What are IgG bands? eCollection 2017. CSF actively serves your body with important functions that include: If your physician suspects inflammation in your central nervous system, they will order a CSF oligoclonal banding. Find out more about MS, including what, Relapsing-remitting multiple sclerosis (MS) is the most common type of MS. Here are 12 simple and fun! Tiu VE, Popescu BO, Enache II, Tiu C, Terecoasa E, Panea CA. Submissions should not have more than 5 authors. Some doctors may perform a lumbar puncture using medical imaging for guidance, such as an ultrasound or interventional radiology. Had clear MRI's of both brain and spine in January. higgs-boson@gmail.com. The institution of Dr. Clardy has received research support from Western Institute for Veteran Research. sharing sensitive information, make sure youre on a federal Lumbar puncture (spinal tap), Oligoclonal banding, serum, and spinal fluid. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. CSF is the clear fluid that flows in the space around the spinal The person conducting the test will clean your back with antiseptic. This article discusses the link between OCBs and MS and what the testing involves. We herein review central and peripheral nervous system conditions associated with OCBs and discuss their relation with pathogenetic mechanisms. Our website services, content, and products are for informational purposes only. WebOligoclonal Banding, Serum Useful For Diagnosis of multiple sclerosis; especially useful in patients with equivocal clinical presentation and radiological findings Determining number of serum oligoclonal bands in order to calculate the number of cerebrospinal fluid-specific bands present Method Name Only orderable as part of a profile. Normal Reports | The presence of OCBs in the CSF is an important factor in diagnosing MS. Dr. Greenlee has received publishing royalties from a publication relating to health care. WebOligoclonal bands are found in up to 95 percent of patients with clinically definite MS . Epub 2022 Apr 22. These findings, however, are not specific for MS as CSF-specific IgG synthesis may also be found in patients with other neurologic diseases including infectious, inflammatory, cerebrovascular, and paraneoplastic disorders. 2019 April 09; 2019:92, The oligoclonal band (OCB) assay requires paired cerebrospinal fluid (CSF) and serum samples. However, their presence alone does not mean that a person definitely has MS. A doctor will need to conduct additional testing to determine the presence of MS. To test OCB levels, a doctor will need to perform a CSF oligoclonal banding test, which involves inserting a needle into the spine to collect CSF. Absorbing shocks to your central nervous system, Circulating nutrients through your bloodstream, Sending messages to different parts of the brain, Tingly shock-like feelings from particular neck movements, Systemic lupus erythematosus, which is an autoimmune disease that causes widespread inflammation in your body, Human immunodeficiency virus (HIV) infection, which creates complications in your central nervous system, Stroke, which can result in permanent neural damage to the bodys communication with the central nervous system, Discomfort and pain at the injection site. Submit only on articles published within 6 months of issue date. All rights reserved. Lumbar puncture is widely used and considered safe. Some people have a headache after a lumbar puncture. A positive test might also indicate that you have: As always, give your doctor complete information on what medications you take. The presence of 2 or more unique CSF (n.d.) Retrieved from. MS is a disease that affects the CNS, which consists of the brain and spinal cord. Any ideas what's going on? Fortini AS, Sanders EL, Weinshenker BG, Katzmann JA: Cerebrospinal fluid oligoclonal bands in the diagnosis of multiple sclerosis, isoelectric focusing with the IgG immunoblotting compared with high resolution agarose gel electrophoresis and cerebrospinal fluid IgG index. Neurology. Would you like email updates of new search results? Clin Chem Lab Med. Mayo Clinic. This particular marker is called 18 KD (IGG) Band and hence is a IgG antibody marker. Clipboard, Search History, and several other advanced features are temporarily unavailable. The presence of oligoclonal band is Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series. CSF oligoclonal banding is a test to look for inflammation-related proteins in the cerebrospinal fluid (CSF). Learn more. Your email address, e.g. -, N Engl J Med. Cerebrospinal fluid (CSF) is the liquid that protects and cushions your brain and spinal cord. This test involves a lumbar puncture, or spinal tap, which takes place at a hospital or clinic. The institution of Dr. Peterson has received research support from Kronus. brain herniation if a brain mass is present. CSF is used in the diagnosis of multiple sclerosis (MS) by identifying increased intrathecal IgG synthesis qualitatively (oligoclonal bands). Theyll send the CSF to a laboratory for analysis. The diagnosis of multiple sclerosis (MS) is dependent on clinical, radiological, and laboratory findings. The diagnostic process will also involve the doctor: If elevated OCB levels are present but a person does not fit the criteria for MS, a doctor will likely continue to search for the underlying cause. What We Know, have any neurological illnesses or conditions. This test is usually ordered if your doctor thinks you may have MS. Please enable it to take advantage of the complete set of features! Corrective measures and identification of specialized laboratories with expertise in the field are fundamental to applying this useful technique in clinical practice. The institution of Dr. Clardy has received research support from Sumaira Foundation for NMO. 2022 Sep;59(6):391-404. doi: 10.1080/10408363.2022.2039591. Oligoclonal bands: An immunological and clinical approach. The procedure can vary depending on the doctors practices and the persons health status. CreutzfeldtJakob disease immunoassay panel with CSF 14-3-3, tau, and S100B proteins was negative. Zhonghua Yi Xue Za Zhi (Taipei). Centrifuge and aliquot serum within 2 hours of collection. Accessibility Address correspondence to the author at: Division of Clinical Biochemistry, Department of Laboratory Medicine, Dr. Everett Chalmers Regional Hospital, Horizon Health Network, Fredericton, New Brunswick, Canada E3B 5N5. Am J Clin Pathol. Management of WebWhen the oligoclonal band assay detects 2 or more unique IgG bands in the cerebrospinal fluid (CSF), the result is positive. CSF is used in the diagnosis of multiple sclerosis (MS) by identifying increased intrathecal IgG synthesis qualitatively (oligoclonal bands). The institution of Dr. Clardy has received research support from NIH/NINDS. Objective: Describe the clinical characteristics of patients with matched oligoclonal bands in paired cerebrospinal fluid (CSF) and serum samples. Once the sample is retrieved, it is analyzed in a medical laboratory., Normal results are reported when no immunoglobulin proteins, called oligoclonal bands, are found in your cerebrospinal fluid.. These findings, however, are not specific for MS as CSF-specific IgG synthesis may also be found in patients with other neurologic diseases including infectious, inflammatory, cerebrovascular, and paraneoplastic disorders. The presence of oligoclonal bands in CSF, but not serum, is indicative of local Clin Chem Lab Med. Please enable it to take advantage of the complete set of features! The clinical significance of matched oligoclonal Oligoclonal bands are multiple distinct bands in the zone of the CSF pattern that are not present in serum. But it can also be used to treat disorders that cause overactive muscles or pain. HHS Vulnerability Disclosure, Help Diagnosis of multiple sclerosis; especially useful in patients with equivocal clinical presentation and radiological findings, Isoelectric Focusing (IEF) with IgG Immunoblot Detection. The presence of oligoclonal bands (OCBs) of immunoglobulin G (IgG) in CSF provides evidence for the occurrence of a humoral immune response, but it is not always appreciated that the oligoclonal IgG may have originated in the serum. Systemic inflammation or monoclonal gammopathy? The assay uses reagents from Helena Laboratories. If the CSF protein concentration is >200 mg/dL, even high immunoglobulin production in the central nervous system can be obscured by the presence of plasma proteins. The .gov means its official. allowed for additional confirmatory or additional reflex tests. Discover some of the causes of dizziness and how to treat it. Am J Clin Pathol. The institution of Dr. Paz Soldan has received research support from Western Institute for Biomedical Research. 1994 Aug;57(8):897-902, 2. The diagnosis of multiple sclerosis (MS) is dependent on clinical, radiological, and laboratory findings. Simonsen CS, Flemmen H, Lauritzen T, Berg-Hansen P, Moen SM, Celius EG. 1). 1. 2022;109:129-163. doi: 10.1016/bs.acc.2022.03.004. Healthline Media does not provide medical advice, diagnosis, or treatment. For assistance, contact. 2021 Laboratory Corporation of America Holdings and Lexi-Comp Inc. All Rights Reserved. eCollection 2023. Your role and/or occupation, e.g. Last medically reviewed on June 15, 2016, A cerebrospinal fluid (CSF) test can be used to diagnose many conditions, from neurological disorders to infectious diseases. This pattern, multiple CSF bands with some accompanying serum bands, should be differentiated from the pattern of multiple similar CSF and serum bands present in systemic inflammation (1) and from monoclonal gammopathy, where 1 or 2 identical bands are found in CSF and serum (2). 1980 Sep;8(3):241-7 It feels just like when the dentist's Novocaine is wearing off. 2018 Jun 27;56(7):1071-1080, 5. Clipboard, Search History, and several other advanced features are temporarily unavailable. I've been having this dizziness and light headed for more than Im female and Im only 25 but my symptoms started at 23. 1975 Aug;52(2):111-20 Two types of antibodies are detected in the Western blot test. Disclosure: Dr. Rodenbeck has nothing to disclose. Labs & Appointments Toggle Labs & Appointments, Billing & Insurance Toggle Billing & Insurance, Diseases & Conditions Toggle Diseases & Conditions, OnDemand Testing Toggle OnDemand Testing, Testing by Disease & Condition Toggle Testing by Disease & Condition, Testing & Services For Toggle Testing & Services For, Hospitals & Physician Systems Toggle Hospitals & Physician Systems, Managed Care Health Plans Toggle Managed Care Health Plans, Lab Data Integrations & Tools Toggle Lab Data Integrations & Tools, Employee Wellness & Testing Toggle Employee Wellness & Testing, Government & Education Toggle Government & Education, Therapeutic Indications Toggle Therapeutic Indications, Development Phase Toggle Development Phase, Compounds & Molecules Toggle Compounds & Molecules. Lisa Johnson has nothing to disclose. His paired cerebrospinal fluid (CSF) and serum samples were sent to the clinical biochemistry laboratory for oligoclonal band analysis by CSF isoelectric focusing and IgG immunofixation (Fig. 2004 Aug 31;15(3):86-94. eCollection 2004 Aug. Bonnan M, Gianoli-Guillerme M, Courtade H, Demasles S, Krim E, Marasescu R, Drau H, Debeugny S, Barroso B. Ann Clin Transl Neurol. However, testing for OCB levels alone is not enough to diagnose MS. The presence of these immunoglobulins can indicate inflammation in the central nervous system (CNS), which can suggest that a person has multiple sclerosis (MS). 1994;57:897-902, 2. Dr. Clardy has received personal compensation in the range of $0-$499 for serving as a Consultant for Clarion. Diagnoses in the second group of patients, with unique CSF OCBs in addition to serum OCBs, resembled those among patients with CSF OCBs alone. The site is secure. Finally, intrathecal humoral immune response can also occur, although rarely, in patients with peripheral neuropathies, particularly in those of inflammatory origin, as a possible consequence of blood-spinal nerve root barrier (BSNRB) damage. The clinical significance of matched oligoclonal bands in the context of possible neuroimmunologic or systemic disease has not been thoroughly investigated. Hi Everyone! No comments have been published for this article. 2021 Aug 4;12:678924. doi: 10.3389/fneur.2021.678924. 1988 Apr 21;318(16):1012-20 Ann Clin Biochem 1990;27:436-443; Hortin GL: Amino Acids, Peptides, and Proteins. This is particularly true if they dont find similar bands in your blood. WebMD does not provide medical advice, diagnosis or treatment. The assay uses reagents from Helena Laboratories. Oligoclonal bands represent limited classes of antibodies that are . Ann Clin Biochem. I also have numbness in my left thumb and left toes (occasionally on the right too) and twitches in my legs. Lines and paragraphs break automatically. Oligoclonal immunoglobulin G (IgG) bands (OCBs) are a useful diagnostic tool to detect a central humoral response. Both serum and spinal fluid are required. Your last, or family, name, e.g. doi: 10.1371/journal.pone.0186842. The presence of 2 or more unique CSF oligoclonal bands was reintroduced as one of the diagnostic criteria for MS in the 2017 revised McDonald criteria. While OCGB negative patients are unlikely to develop clinically definite (CD) MS, OCGB positivity may lead to an erroneous diagnosis in
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