Cerebrospinal Fluid (CSF) Oligoclonal Band Screen

Written by Elea Carey
Medically Reviewed by George Krucik, MD

What Is a Cerebrospinal Fluid Oligoclonal Band Screen?

Cerebrospinal fluid (CSF) is the liquid that protects and cushions your brain and spinal cord.

A CSF oligoclonal band (OB) screen looks for antibodies in your CSF. Large bands of antibodies suggest an infection or other disease. If similar bands are not present in your blood, you may have multiple sclerosis.

The test is also known as:

  • CSF oligoclonal banding
  • cerebrospinal fluid - immunofixation

What Is the Purpose of the CSF OB Screen?

The CSF OB screen is often used to test for multiple sclerosis (MS). It can also be used to diagnose other inflammatory conditions and neurological diseases.

A normal result is no bands or just one band. Multiple bands are an indicator that something is wrong. This is particularly true if similar bands aren’t found in the blood.

Why Has My Doctor Ordered This Test?

This test is usually ordered if your doctor thinks you may have MS. According to the Mayo Medical Laboratories, the CSF OB screen is positive in 70 to 80 percent of MS patients. (Mayo Medical Laboratories)

A positive test might also indicate that you have:

  • neurosyphilis
  • encephalitis
  • meningitis
  • Lyme disease

How Should I Prepare for the CSF OB Screen?

Your doctor will need to know if you:

  • are taking any blood thinning medications
  • have a history of back or spine problems
  • have any neurological illnesses or conditions

As always, give your doctor complete information on what medications you take. Make certain to include both prescription and over-the-counter medicines.

If your work is strenuous and might involve your back, tell your doctor. You may need to arrange to take the day of your test off. You should expect to rest for at least an hour after your test.

What Happens During the CSF OB Screen?

This test is conducted by lumbar puncture. This procedure is also sometimes known as a spinal tap.

The lumbar puncture for your CSF OB screen takes place at a hospital or clinic. You will need to change into a hospital gown with the back open. This gives the person conducting the test easy access to your spine.

You will be asked to turn on your side and expose your back. You may also sit up and bend over.

The person conducting the test will clean your back with antiseptic. Next, they will apply a local anesthetic. After a few moments, it will begin working. The anesthetic will reduce or eliminate the pain of needle insertion.

You will be asked to hold very still. A hollow needle will be inserted into your lower spine. A small amount of CSF will be withdrawn. The needle will be removed.

The person conducting the test will clean and cover the puncture. The CSF will be sent to a laboratory for analysis. You can expect to rest for an hour or two after your test. Your doctor may suggest you take a mild pain reliever.

What Are the Risks of a CSF OB Screen?

Lumbar puncture is widely used and considered safe. However, there are some medical risks, including:

  • bleeding into the spine
  • allergic reaction to anesthetic
  • infection
  • damage to the spinal cord (if you move)
  • brain herniation (if a brain mass is present)

There is usually some discomfort during and shortly after the test.

Many people have a headache after a lumbar puncture. This should go away within 24 hours. Let your doctor know if it does not.

What Are the Next Steps?

Your test results should be ready in a couple of days. Your doctor will read them and discuss likely next steps.

The presence of no oligoclonal bands or one band is normal. More than one band is an indicator of illness. In this case, further tests will be necessary to determine the cause of any disease.

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