csf oligoclonal banding…

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what the risks are cerebrospinal fluid, immunofixation, this is a test performed on cerebrospinal fluid, csf, clear fluid that circulates, in the space surrounding the spinal cord, brain, csf contains substances that markers, oligoclonal bands, immunoglobulins that suggest inflammation, the central nervous system, presence of oligoclonal bands a sign of multiple sclerosis, a lumbar puncture, spinal tap, fluid is sent, analysis, patients, either sit up, lie down on side with back parallel, bed and chin tucked under and legs curled, in the fetal position, healthcare provider, use the bony protrusions, the hip, the most appropriate location to remove fluid, l3-l4 vertebral level, subsequently iodine, clean off the area, a sterile sheet, draped over the surrounding area, in infants, small children, a local anesthetic cream to numb the skin, applied, 1 hour, in adults, lidocaine, injected under the skin initially, deeper such that tissue beneath the skin, numbed, a thin, 20-gauge needle, inserted, interspace between the vertebra, depending on how much subcutaneous tissue there, require shallow, deeper penetration, the needle, an audible pop, the needle penetrates the dura, membrane surrounding the spinal cord, encasing the fluid, fluid, flow out, the needle, collected in plastic containers, under normal circumstances, opening pressure, measured, a manometer, 20-30 cc of spinal fluid, collected, sent, evaluation under the microscope, under experienced hands there should not be any pain, a feeling of pressure, the needle is inserted but, appropriate anesthetic, should not hurt, feel numbness shooting down the leg, due to irritation of a nerve root, subsides, the needle is withdrawn, following the procedure, patient is advised to remain lying down, an hour, two, prevent low-pressure headache, entire procedure takes approximately 20 minutes, this test helps support, does not confirm, diagnosis of multiple sclerosis, ms, presence of oligoclonal bands, in the csf must be interpreted, in the context of clinical findings, laboratory results, negative result, less bandings found, in the csf is normal, test results, positive, bandings found, in the csf, in the blood serum, indicate multiple sclerosis, risks of lumbar puncture, hypersensitivity, allergic, reaction, anesthetic, discomfort, headache, bleeding, spinal canal, brain herniation, performed on a person, increased intracranial pressure, resulting in brain damage, death, spinal cord, does not occur, the needle is inserted below the level at which the spinal cord ends, needle, irritate a nerve root which results in transient numbness, tingling, in the leg, goes away, the needle is re-adjusted, to confirm multiple sclerosis, clinical symptoms, consistent mri findings must also be present.