Abstract
Introduction: The usefulness of cerebro-spinal fluid (CSF) immunological tests (IgG index, Reiber diagram and IgG Oligoclonal bands (OCB) detection) in multiple sclerosis (MS) diagnosis has been discussed since diagnostic criteria were modified in 2010. Our aim is to evaluate the comparative performances of these tests in MS diagnosis.Methods: Serum and CSF samples were collected (at the same time) from 100 patients with suspicion of MS diagnosis. IgG index was calculated and interpreted using Reiber diagram. IgG-OCB were analyzed by isofocusing test.Results: Patients were divided into « MS »(n = 67) and « non MS »(n = 33) groups based on clinical and radiological criteria. Regarding MS patients, IgG index was ≥ 0,7 in 57,5 % of cases. Reiber diagram interpretation concluded to an IgG intrathecal synthesis in 57,5 % of cases and a blood-brain barrier dysfunction in 15 % of cases. CSF isofocusing test revealed an OCB positivity in 77,6 % of cases. Specificities of IgG index and isofocusing test in MS diagnosis were 88,9 % and 81,8 % respectively.Conclusion: Frequency of OCB positivity in Tunisian MS patients is intermediate between those reported in occidental and asiatic countries. In routine practice, isofocusing test is the most sensitive for MS diagnosis whereas quantitative tests provide faster results.
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