Immunofixation and Protein Electrophoresis (CSF)

Does this test have other names?

IPE CSF, CSF protein electrophoresis, immunofixation electrophoresis

What is this test?

This test looks for certain proteins in a sample of your cerebral spinal fluid (CSF).

CSF is the fluid that surrounds your brain and spinal cord. This test uses an electrical current on a CSF sample to separate out certain types of protein called immunoglobulins. Normally, your CSF contains little protein. An increase in the amount of these proteins could be a sign of certain inflammatory and immune disorders, including multiple sclerosis (MS) and meningitis.

When tested using immunofixation, CSF in people with MS shows a pattern called oligoclonal bands, as well as higher levels of immunoglobulins. Both of these help confirm an MS diagnosis. Oligoclonal bands are not normal in healthy CSF.

Why do I need this test?

You may have this test if your doctor suspects you have MS, a degenerative nerve disease, or another nervous system disorder.

What other tests might I have along with this test?

Your doctor may also order a test to measure the level of glucose in your CSF. If meningitis is a possibility, your doctor may order a gram stain of your CSF to look for infection.

Your doctor may also order blood tests, including:

  • Albumin

  • Prealbumin

  • Immunoglobulins

What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your health care provider.

Results are given in milligrams per deciliter (mg/dL). The normal range for CSF protein in adults is 15 to 45 mg/dL.

If your levels are higher, it may mean that you have a medical problem. Along with MS, conditions that may cause oligoclonal bands of immunoglobulins in the CSF include meningitis, Lyme disease of the central nervous system, autoimmune diseases, and brain tumors.

How is this test done?

This test requires obtaining a sample of your CSF. Your doctor will take the sample through a lumbar puncture, using a thin needle. The needle will be pushed into your lower back, and fluid will be removed.

Does this test pose any risks?

A lumbar puncture, or LP, carries these possible risks:

  • Headaches

  • Infection

  • Bleeding

  • Tumors

  • Numbness  

If the joints in your lower spine are degenerated, such as may happen with arthritis, it may be hard for the doctor to get a good sample of your CSF. Talk with your doctor so you know exactly what to expect.

What might affect my test results?

Other factors aren't likely to affect your results.

How do I get ready for this test?

You don't need to prepare for this test. But blood thinners and over-the-counter pain relievers, like aspirin, can cause bleeding during the lumbar puncture. Be sure your doctor knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.