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CSF total protein

CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF).

How the Test is Performed

A sample of CSF is needed (1 to 5 ml). A lumbar puncture (spinal tap) is the most common way to collect this sample. Rarely, other methods are used for collecting CSF such as:

  • Cisternal puncture
  • Ventricular puncture
  • Removal of CSF from a tube that is already in the CSF, such as a shunt or ventricular drain.

After the sample is taken, it is sent to a lab for evaluation.

Why the Test is Performed

Your doctor may order this test to help diagnose tumors, infection, inflammation of several groups of nerve cells, vasculitis, blood in the spinal fluid, or multiple sclerosis (MS).

Normal Results

The normal protein range varies from lab to lab, but is typically about 15 to 60 mg/dL.

Note: mg/dL = milligrams per deciliter

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

An abnormal protein level in the CSF suggests a problem in the central nervous system.

Increase protein level may be a sign of a tumor, bleeding, nerve inflammation, or injury. A blockage in the flow of spinal fluid can cause the rapid buildup of protein in the lower spinal area.

A decrease in protein level can mean your body is rapidly producing spinal fluid.

References

Griggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 403.

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 59.

Updated: 5/28/2013

Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles CA; Department of Surgery at Los Robles Hospital, Thousand Oaks CA; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Surgery at Cheyenne Regional Medical Center, Cheyenne WY; Department of Anatomy at UCSF, San Francisco CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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