A STUDY OF OLIGOCLONAL BAND NEGATIVE MULTIPLE-SCLEROSIS

Objectives-to determine whether oligoclonal band (OCB) negative multip le sclerosis is a reliable diagnosis and, if so, whether it has a dist inctive prognosis. Methods-retrospective and matched prospective compa rison of the clinical and laboratory features of patients with clinica l definite multiple sclerosis with and without intrathecal synthesis o f oligoclonal IgG. Results-thirty four patients were identified with a pparent OCB negative clinically definite multiple sclerosis. The resul ts of oligoclonal banding proved to have been equivocal in 14 of 34; t he clinical diagnosis of multiple sclerosis was questionable in 8 of 3 4. The remaining 12 patients with ''true'' OCB negative multiple scler osis were significantly less disabled than matched OCB positive contro ls. Re-examination of CSF-serum pairs from six OCB negative patients s howed that three remained OCB negative while three showed evidence of intrathecal synthesis of OCBs. Conclusions-OCB negative clinically def inite multiple sclerosis is rare and should be diagnosed with caution; in unequivocal cases it seems to have a relatively benign prognosis.