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Cited by 627Multiple Sclerosis Research StudiesPeripheral Neuropathies and DisordersInfectious Diseases and Tuberculosis

Recommended Standard of Cerebrospinal Fluid Analysis in the Diagnosis of Multiple Sclerosis: A Consensus Statement

Freedman, Mark S., Thompson, Edward J., Deisenhammer, Florian, Giovannoni, Gavin, Grimsley, Guy, Keir, Geoffrey, Öhman, Sten, Racke, Michael K. +4 more·2005·Archives of Neurology
DOI 10.1001/archneur.62.6.865
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Abstract

New criteria for the diagnosis of multiple sclerosis (MS) were published as the result of an internationally formed committee. To increase the specificity of diagnosis and to minimize the number of false diagnoses, the committee recommended the use of both clinical and paraclinical criteria, the latter involving information obtained from magnetic resonance imaging, evoked potentials, and cerebrospinal fluid (CSF) analysis. Although rigorous magnetic resonance imaging requirements were provided, the "new criteria paper" fell short in terms of guidelines as to how the CSF analysis should be performed and simply equated the IgG index with isoelectric focusing, without any justification. The spectrum of parameters analyzed and methods for CSF analysis differ worldwide and often yield variable results in terms of sensitivity, specificity, accuracy, and reliability, with no decided "optimal" CSF test for the diagnosis of MS. To address this question specifically, an international panel of experts in MS and CSF diagnostic techniques was convened and the result was this article, representing a consensus of all the participants. These recommendations for establishing a standard for the evaluation of CSF in patients suspected of having MS should greatly complement the new criteria in ensuring that a correct diagnosis of MS is being made.

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Crossref · 10.1001/archneur.62.6.865

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  • Multiple studies provide evidence that in adult patients with CIS, CSF OCBs are an independent predictor of the risk of a second attack when controlling for demographic, clinical, treatment, and MRI variables.

    “Multiple studies provide evidence that in adult patients with CIS, CSF OCBs are an independent predictor of the risk of a second attack when controlling for demographic, clinical, treatment, and MRI variables. 61-69”

    From Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria (2018) · cites this paper as [64]

  • In some patients with suspected MS, further supportive information can be obtained from cerebrospinal fluid examination and neurophysiological testing.

    “but in some patients, further supportive information can be obtained from cerebrospinal fluid examination and neurophysiological testing.”

    From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [14]

  • Qualitative assessment of IgG using isoelectric focusing and immunofixation is the optimal method for detection of OCBs.

    “Qualitative assessment of IgG using isoelectric focusing and immunofixation is the optimal method for detection of OCBs.14”

    From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [14]

  • CSF findings in MS include a normal or mildly raised white cell count (<25 cells/cm3, predominantly lymphocytes) and protein (usually <1g/L), a raised IgG index and IgG oligoclonal bands (OCBs) not present in serum.

    “CSF findings in MS include a normal or mildly raised white cell count (<25 cells/cm 3 , predominantly lymphocytes) and protein (usually <1g/L), a raised IgG index and IgG oligoclonal bands (OCBs) not present in serum.14”

    From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [14]

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Authors
Freedman, M. S., Thompson, E. J., Deisenhammer, F., Giovannoni, G., Grimsley, G., Keir, G., Öhman, S., Racke, M. K., Sharief, M., Sindic, C. J. M., Sellebjerg, F., & Tourtellotte, W. W.
Affiliations
University of Ottawa (CA)
ORCID
Venue
Archives of Neurology
Publisher
American Medical Association (AMA)
Published
2005-06-01
Volume
62
Issue
6
ISSN
0003-9942 (ISSN-L)
DOI
10.1001/archneur.62.6.865
OpenAlex
W2123646700
Cited by
41
References
34
Citations by year
2023: 1 · 2020: 3 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 3 · 2012: 5
FWCI
2.22
Type
journal article
Language
en
Open access
closed
Locations
Archives of Neurology (publishedVersion)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
  • Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
Keywords
multiple sclerosis, cerebrospinal fluid analysis, diagnostic criteria, IgG index, isoelectric focusing, magnetic resonance imaging, evoked potentials, diagnostic standardization, false diagnosis

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