A 26-year-old female presents with optic neuritis and paresthesias. Brain MRI reveals periventricular white matter demyelinating plaques. What CSF finding supports the diagnosis?
Answer and explanation
Correct answer: C. Presence of oligoclonal IgG bands
- Step 1: Neurological deficits separated in time and space with periventricular white matter lesions on MRI indicate multiple sclerosis.
- Step 2: The demonstration of two or more unique oligoclonal immunoglobulin G (IgG) bands in cerebrospinal fluid that are absent in paired serum confirms intrathecal antibody synthesis.
Answer
Presence of oligoclonal IgG bands.
Why not the others: Neutrophilic pleocytosis reflects acute bacterial infection. Profoundly low glucose indicates bacterial or tuberculous leptomeningeal inflammation. Xanthochromia indicates hemoglobin breakdown following subarachnoid hemorrhage.
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