Walsh & Hoyt: Laboratory and Neuroimaging Findings

The CSF in patient with neuromyelitis optica may show changes similar to those seen in typical MS. As noted above, the ICP usually is normal, but it is elevated in some patients. The protein content of the CSF is usually slightly increased, and there may be a mild lymphocytic pleocytosis. The IgG content is often increased, as is the CSF IgG index. Oligoclonal bands may be present, and MBP is not only present but extremely elevated. Neuroimaging studies show large, multifocal areas of extensive demyelination, often with mass effect. In some cases, these lesions are similar in appearance to neoplasms or abscesses.