Demonstration of cerebrospinal fluid oligoclonal banding in neurologic diseases by agarose gel electrophoresis and immunofixation.

Demonstration of an oligoclonal immunoglobulin pattern in cerebrospinal fluid by a commercial agarose gel electrophoresis system and immunofixation were evaluated in the service clinical laboratory of a university hospital. In 303 patients, 45 with clinically definite multiple sclerosis and 209 with other neurologic diseases, the sensitivity of oligoclonal banding for multiple sclerosis was 71%, and the specificity, 83%. Oligoclonal banding was frequent in inflammatory disease, tumor/pseudotumor or vascular diseases of the central nervous system (35%, 36% and 26%, respectively) and less frequent in degenerative central nervous system disease and peripheral neuropathy (5.2% and 15%). No patient with non-neurologic disease had oligoclonal banding. The addition of an immunochemical step (immunofixation) did not increase sensitivity and only minimally increased specificity. It did permit distinction in selected cases between immunoglobulin and other molecules with identical electrophoretic mobility.