Examination of the cerebrospinal fluidLiquordiagnostics
Cerebrospinal fluid (liquor) can be obtained by lumbar puncture and shows conspicuous findings in about 95% of patients with multiple sclerosis. For this purpose, a hollow needle is inserted between two vertebrae in the area of the lumbar spine and some cerebrospinal fluid is removed. This water is then evaluated in a laboratory and examined for certain parameters. A typical MS finding is the increased occurrence of certain proteins in the spinal fluid (monoclonal bands). Inflammatory cells are also often found increased or elevated.
Saving the diagnosis
There are defined criteria that must be met in order to make a reliable diagnosis of multiple sclerosis. These criteria are called McDonald criteria. The diagnosis is considered confirmed when a spatial and temporal spread (dissemination) can be determined.
This means that the centres of inflammation must occur at different locations in the brain and new foci must appear over the course of the disease. All symptoms should be considered and other clinical pictures that can cause the same symptoms must be considered. Although both the temporal and spatial distribution of centres of inflammation in the brain are typical signs of multiple sclerosis, they can also be caused by other diseases.
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