On the diagnostic value of different CSF investigations in multiple sclerosis

An assessment was made of the relative values of different methods of calculating intrathecal IgG synthesis in multiple sclerosis. In 60 patients with definite, probable or possible multiple sclerosis the IgG/protein and IgG/albumin ratios, the IgG index, the Tourtellotte formula and the graphic evaluation according to Reiber were applied. All the patients had oligoclonal IgG in the CSF. Reiber's method was the most sensitive, yielding 66% of abnormal findings. Only the cell count showed significant differences between active and inactive stages. There was a correlation between the cell count and the daily rate of intrathecal IgG synthesis and between the latter and the number of oligoclonal bands in CSF, but none of these parameters correlated with duration of disease or the number of previous bouts.