A 36yearold woman complained of intermittent blurred vision

A 36-year-old woman complained of intermittent blurred vision and numbness and weakness in her left leg that had persisted for longer than 3 weeks On examination, vertical (involuntary back-and-forth or circular movements of eyes) was noted on upward gaze. CSF as drawn and the specimen was clear and colorless with normal cell count. The CSF total protein level was 49 mg/dl with an IgG of 8.1 mg/dL. Electrophoresis of the patient\'s serum and CSF revealed the following pattern: more than two bands in CSF (seen in Fig. 11-7) and a polyclonal pattern on SPE. What is the significance of the CSF protein bands indicated by the arrows? What conditions would produce this type of CSF protein electrophoresis pattern? What other tests would be helpful in the investigation of this patient\'s diagnosis? What laboratory test can be useful for monitoring the course of this patient\'s condition?

Solution

1. They are myelin basic proteins which are abnormal proteins which indicates the demylenation of neuronal axis. Its measurement is used to monitor the course of disease and the effect of treatment.

2. These abnormal proteins are produced due to multiple sclerosis, tumors and other factors

3. Other tests which could be helpful are M- Protein quantification, degree of suppression of other immunoglobulins, determination of quantity of light chain myelomas.

4. M- Protein quantification will be useful for monitoring the course of this patients condition.