Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report.

作者：Mats Andersson, Jose Carlos Alvarez-Cermeño, Gaetano Bernardi, I. Cogato, Pam Fredman, Jette Lautrup Frederiksen, S. Fredrikson, Paolo Gallo, L.M.E. Grimaldi, M. Grønning, Geoff Keir, Karel J.B Lamers, Hans Link, A. Magalhaes, Angelo R. Massaro, Susanne Georgsson Öhman, Hansotto Reiber, Lars Rönnbäck, Myriam Schluep, Edmond Schuller, Christian Sindic, E. Joanne Thompson, María Trojano, Ulrich Wurster · 发表于：Journal of Neurology Neurosurgery & Psychiatry · 年份：1994 · DOI：10.1136/jnnp.57.8.897 · 被引用次数：745 · 研究领域：Multiple Sclerosis Research Studies、Peripheral Neuropathies and Disorders、Viral Infections and Immunology Research

The Committee of the European Concerted Action for Multiple Sclerosis (Charcot Foundation) organised five workshops to discuss CSF analytical standards in the diagnosis of multiple sclerosis. This consensus report from 12 European countries summarises the results of those workshops. It is hoped that neurologists will confer with their colleagues in clinical chemistry to arrange the best possible local practice. The most sensitive method for the detection of oligoclonal immunoglobulin bands is isoelectric focusing. The same amounts of IgG in parallel CSF and serum samples are used and oligoclonal bands are revealed with IgG specific antibody staining. All laboratories performing isoelectric focusing should check their technique at least annually using "blind" standards for the five different CSF and serum patterns. Quantitative measurements of IgG production in the CNS are less sensitive than isoelectric focusing. The preferred method for detection of blood-CSF barrier dysfunction is the albumin quotient. The CSF albumin or total protein concentrations are less satisfactory. These results must be interpreted with reference to the age of the patient and the local method of determination. Cells should be counted. The normal value is no more than 4 cells/microliters. Among evolving optional tests, measurement of the combined local synthesis of antibodies against measles, rubella, and/or varicella zoster could represent a significant advance if it offers higher specificity (not se...