Answered on: 11/6/2013
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Does a lumbar puncture provide 100% proof that someone has MS?
The lumbar puncture is a useful test for diagnosing multiple sclerosis, but it is not sufficient by itself to make a diagnosis. The diagnosis of the disease mainly depends on clinical aspects, that is, the history that you give the neurologist about various symptoms that you have experienced, which may relate to this disease and by a neurological examination by your physician, which indicates anomalies confirming symptoms that you have noted.
If the clinical examination is highly suggestive of MS, magnetic resonance image (MRI) will allow us to confirm the physician’s clinical impressions. The reverse is also true, that is, a normal MRI would eliminate the diagnosis of multiple sclerosis if the neurologist’s clinical impression is that the patient does not have multiple sclerosis.
Lumbar puncture is mainly used in disputed cases. If the clinical history is convincing for a diagnosis of multiple sclerosis, but the MRI is unclear, the presence of anomalies in the analysis of cerebrospinal fluid (CSF) obtained by a lumbar puncture would allow the neurologist to confirm the diagnosis. The analysis of CSF is also useful if the clinical history is not convincing but magnetic resonance strongly suggests the disease. Lumbar puncture is also frequently used for the diagnosis of patients with the primary progressive type of multiple sclerosis.
Despite significant advances made in recent decades in diagnosing the disease, mainly by using MRI, lumbar puncture remains important by adding information that it alone can provide.
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