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CSF oligoclonal banding

CSF oligoclonal banding is a test to look for inflammation-related proteins in the cerebrospinal fluid (CSF). CFS is the clear fluid that flows in the space around the spinal cord and brain.

Oligoclonal bands are proteins called immunoglobulins. The presence of these proteins indicates inflammation of the central nervous system. Oligoclonal bands may be a sign of multiple sclerosis.

Alternative Names

Cerebrospinal fluid - immunofixation

How the Test is Performed

A sample of CSF is needed. A lumbar puncture (spinal tap) is the most common way to collect this sample.

Other methods for collecting CSF are rarely used, by may be recommended in some cases. They include:

  • 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 testing.

Why the test is performed

This test helps support the diagnosis of multiple sclerosis (MS). However, it does not confirm the diagnosis. Oligoclonal bands in the CSF can also be seen in other illnesses.

Normal Results

Normally, one or no bands should be found in the CSF.

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

There are two or more bandings found in the CSF and not in the blood. This may be a sign of multiple sclerosis or other inflammation.

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.

Houtchens MK, Lubin FD, Miller AE, Khoury SJ. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 54.

Lechner-Scott J, Spencer B, de Malmanche T, et al. The frequency of CSF oligoclonal banding in multiple sclerosis increases with latitude. Mult Scler. July 2012;18:974-982.

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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