Читать книгу Neurology - Charles H. Clarke - Страница 74

CSF is essentially acellular. Few cells are found in normal CSF: most laboratories quote <5 white cells/mm³ as normal, but any cells should provoke suspicion. Cells are typically lymphocytes: macrophages or neutrophils are almost certainly disease‐related. Red blood cells are always abnormal, though the commonest cause is a traumatic tap. Cytology/flow cytometry may be needed, for example in malignant meningitis and haematological malignancy.

Bacteria and fungi can be isolated by culture and seen on microscopy. Viruses: PCRs are specific but variably sensitive. Whole genome and next generation sequencing techniques are available. Oligoclonal banding pattern can identify the relative production of monoclonal or oligoclonal responses, useful in inflammatory diseases. The antigenic target in MS of oligoclonal bands remains a mystery.