A short introduction to MULTIPLE SCLEROSIS - Page 3

Cerebrospinal fluid (CSF)

Analysis of the cerebrospinal fluid, obtained by lumbar puncture, may be particularly useful in confirming the diagnosis when clinical examination and other tests have proved inconclusive. In 90 per cent of people with MS, it reveals abnormal levels of certain

immune system proteins, particularly immunoglobulin G (lgG). Analysis of these proteins reveals a characteristic pattern referred to as oligoclonal bands (McDonald 1998). This pattern appears in only 2 per cent of people without MS. The pattern occurs in other diseases, but ones which are unlikely to be confused with MS (Rolak 1996). The main difficulty with this test is that about a third of people develop severe headache after the procedure, the pain of which can last several days. Lying prone after the sample has been drawn may help the puncture site to close, and drinking plenty of fluids will replace those lost during the procedure (Holland et al 1996).

MS usally follows one of four patterns:

  • Benign
  • Relapsing - remitting
  • Secondary progressive
  • Primary progressive

~ Benign - Mild, infrequent attacks, followed by full recovery; with on permanent disability after 15 or more years; affects about 20 per cent of people with MS

~ Relapsing - remitting - Attacks, where symptoms come on quickly over a day or or a few days, are followed by a period of remission for days, month, or even years, during which symptoms ease or disappear. During a relapse, old symptoms may recur or new ones may appear. Disability may become more severe with each attack. Hospital treatment is usually required for the worst relapses. Over 70 per cent of people start of with this form of MS.

~ Secondary progressive - Begins as relapsing - remitting MS, but after repeated attacks, remissions cease. Symptoms progressively worsen.
Around 50 per cent of people will eventually develop secondary progressive MS, usually within 10 to 15 years of onset Some people can continue to have attacks as well as progressive symptomns.

~ Primary progressive - Symptoms and disability worsen from the outset, with no distinct relapses. Rates of progression vary. Affects about 10 per cent of people with MS.

I have been informed that there may be a reform of the above to:

Relapsing - remitting

Secondary progressive

Primary progressive

Relapsing - remitting progressive