A study of oligoclonal band negative multiple sclerosis

OBJECTIVES--To determine whether oligoclonal band (OCB) negative multiple sclerosis is a reliable diagnosis and, if so, whether it has a distinctive prognosis. METHODS--Retrospective and matched prospective comparison of the clinical and laboratory features of patients with clinical definite multipl...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1996-01, Vol.60 (1), p.27-30
Main Authors: Zeman, A Z, Kidd, D, McLean, B N, Kelly, M A, Francis, D A, Miller, D H, Kendall, B E, Rudge, P, Thompson, E J, McDonald, W I
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Disabled Persons
Female
Humans
Immunoglobulin G - immunology
Immunoglobulins - blood
Immunoglobulins - cerebrospinal fluid
Magnetic Resonance Imaging
Male
Medical sciences
Multiple Sclerosis - classification
Multiple Sclerosis - diagnosis
Multiple Sclerosis - immunology
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
Oligoclonal Bands
Prognosis
Prospective Studies
Reproducibility of Results
Retrospective Studies
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Summary:OBJECTIVES--To determine whether oligoclonal band (OCB) negative multiple sclerosis is a reliable diagnosis and, if so, whether it has a distinctive prognosis. METHODS--Retrospective and matched prospective comparison of the clinical and laboratory features of patients with clinical definite multiple sclerosis with and without intrathecal synthesis of oligoclonal IgG. RESULTS--Thirty four patients were identified with apparent OCB negative clinically definite multiple sclerosis. The results of oligoclonal banding proved to have been equivocal in 14 of 34; the clinical diagnosis of multiple sclerosis was questionable in 8 of 34. The remaining 12 patients with "true" OCB negative multiple sclerosis were significantly less disabled than matched OCB positive controls. Re-examination of CSF-serum pairs from six OCB negative patients showed that three remained OCB negative while three showed evidence of intrathecal synthesis of OCBs. CONCLUSIONS--OCB negative clinically definite multiple sclerosis is rare and should be diagnosed with caution; in unequivocal cases it seems to have a relatively benign prognosis.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.60.1.27