No, a spinal tap (lumbar puncture) does not always show signs of Multiple Sclerosis (MS), though it's a key diagnostic tool, with about 90-95% of MS patients showing specific proteins like oligoclonal bands, but 5-10% never do, and other conditions can mimic the findings. It's used alongside clinical exams, medical history, and crucial MRI scans, as a negative tap doesn't rule out MS, nor does a positive one confirm it alone.
Lumbar puncture, also known as a spinal tap, in which a small sample of cerebrospinal fluid is removed from the spinal canal for lab testing. This sample can show changes in antibodies that are linked to MS. A spinal tap also can help rule out infections and other conditions with symptoms similar to MS.
Magnetic resonance imaging (MRI) and MS
Magnetic resonance imaging scans (MRI) are vital in diagnosing MS and in monitoring and predicting how someone's MS is changing.
Typically, a person with MS will have a history of symptoms that demonstrate a pattern consistent with MS, but not always. It is this unpredictability that makes the process so challenging. There is no single test, and no specific combination of tests, that will always correctly diagnose multiple sclerosis.
Of all the biological processes, inflammatory markers are probably the best identified. Detection of oligoclonal immunoglobulin bands in the CSF is now established as the single most useful laboratory marker in the CSF to aid in the diagnosis of multiple sclerosis.
Even if spinal tap results are negative for MS, she notes, about 10 percent of people with MS have normal spinal fluid. “And other things [besides MS] can cause a positive result,” she says. Despite these flaws, a spinal tap can be an important tool for MS diagnosis.
What are the early symptoms of multiple sclerosis?
It can take time to get answers because multiple sclerosis is difficult to diagnose. Symptoms like the ones found in MS are seen in other health conditions, so doctors will want to rule these out first. It is quite common to remain undiagnosed even after all the tests for MS.
One of the more obvious first signs of MS is a problem with vision, known as optic neuritis. This is often because it's a more concrete symptom as opposed to vaguer neurological symptoms like numbness and tingling.
More specifically, a brain or head MRI can show if there are any abnormalities in your brain or the surrounding tissues, including, but not limited to: Inflammation and swelling. Structural issues. Abnormal growths or masses.
Symptoms of multiple sclerosis (MS)
Some of the most common symptoms include: feeling extremely tired (fatigue) problems with your eyes or your vision, such as blurred vision or eye pain. numbness or a tingling feeling in different parts of the body.
IgG index (a comparison between IgG levels in the CSF and in the serum) is elevated in many MS patients. Oligoclonal Immunoglobulin Bands can be identified in the CSF of MS patients via electrophoresis. The overall protein level is also slightly elevated - up to 0.1 g/L.
These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.
A normal MRI with MS symptoms
There are rare cases where someone can have MS but their MRI will look clear. This happens. That doesn't mean they can't get a diagnosis of multiple sclerosis, but it does make it significantly more difficult.
A lumbar puncture can help diagnose serious infections, such as meningitis. It also can help diagnose other diseases of the central nervous system, such as Guillain-Barre syndrome and multiple sclerosis. A lumbar puncture may be used to diagnose bleeding around the brain or cancers of the brain or spinal cord.
Research suggests that stress can worsen MS symptoms, triggering flare-ups and increasing fatigue (National Multiple Sclerosis Society). Managing mental health proactively can help stabilize symptoms, improve well-being, and enhance overall quality of life.
Those symptoms include loss of vision in an eye, loss of power in an arm or leg or a rising sense of numbness in the legs. Other common symptoms associated with MS include spasms, fatigue, depression, incontinence issues, sexual dysfunction, and walking difficulties.
Titubation is defined as nodding head tremor with a frequency of 3–4 Hz and may be seen in midline cerebellar disease. 16. This type of tremor can occur in isolation or combined with a postural tremor elsewhere, especially in the arms. 16. Titubation can be seen in 9% of the MS patients.
Invisible symptoms of MS – fatigue, pain, blurred vision, numbness, and brain fog – which often go unnoticed by other people, can also interfere with daily functioning and be just as debilitating.
A wide range of conditions can be mistaken for MS, including: migraine, cerebral small vessel disease, fibromyalgia, functional neurological disorders, and neuromyelitis optica spectrum disorders, along with uncommon inflammatory, infectious and metabolic conditions (1, 3).
Even if spinal tap results are negative for MS, she notes, about 10 percent of people with MS have normal spinal fluid. “And other things [besides MS] can cause a positive result,” she says.
There is a significant association between MS and disturbed vitamin B12 metabolism. Vitamin B12 deficiency should always be looked for in patients with MS.
Other more advanced symptoms include hand weakness, wrist drop (difficulty raising hand), curling fingers, poor sensation. You may notice that you drop items or have difficulty gauging how to pick up an item.
Myelin Basic Protein (MBP) Test
Elevated levels of MBP in the CSF may indicate active demyelination, suggesting that myelin in the central nervous system is being broken down, often seen in MS. This test helps doctors understand whether nerve damage is currently happening in the brain and spinal cord.
The exact cause of Multiple Sclerosis (MS) is unknown, but it's triggered by a combination of genetic susceptibility, environmental factors (like low Vitamin D, infections, smoking, and stress), and immune system dysfunction that leads the body to attack its own nervous system. Triggers that can worsen existing MS include heat, infections, stress, lack of sleep, and childbirth, while factors like smoking, obesity, and low sun exposure increase risk or severity.