CSF Cell Count and Differential

CSF Cell Count and Differential

Differential diagnosis is one of the most common differential diagnoses made when a patient presents with symptoms that are not consistent with other diseases or conditions. Differential diagnosis involves the examination of all possible sources of disease in order to determine which cause(s) may be responsible for a particular symptom.

The differential diagnosis includes many different types of tests such as:

Blood Tests (CBC, CBC/EKG, TB test etc.)

Urine Tests (Antibody screen, Serum creatinine level etc. )

Tissue samples (CT Scan, MRI scan etc.)

Plasma Transfusions (Thyroid stimulating hormone levels, Blood glucose levels etc.)

Cerebrospinal Fluid (CSF) Tests (Lymphocyte counts, Monocytes, eosinophils etc.)

There are several factors that affect the results of any given test. Some of these unknown factors include such things as:

The state of the health of the patient in general

Whether or not the test was performed properly

The skill of the physician who interpreted the results

The medical advances that allow more accurate testing techniques to be developed as time passes

Differential Diagnoses is a form of scientific thought process that allows physicians to identify possible causes for an illness and narrowing them down through a scientific evaluation process. The goal is to eventually be able to identify the most likely cause of the illness, which will lead to the most effective treatment.

Through this process of scientific evaluation, physicians are often able to distinguish between things that are “normal” and things that are “abnormal” when it comes to health. For example, your pulse may be an average of 70 beats per minute when you are relaxed.

If you were to take your pulse and find that it was much higher than this, then you might want to investigate why. You might have a condition called hypertension where the force of blood being pumped by the heart is too strong. On the other hand, if your pulse is much lower than normal this may be a sign of a problem as well.

In situations like this, it is common for the physician to refer you to another physician who specializes in diagnosing and treating conditions related to the heart or other organs of the body. This is because each different organ in the body can become sick in various different ways, and sometimes there is more than one specialist that can help with these types of illnesses.

However, in this article we will focus on the medical field that is most related to this type of problem and that is the Neurologist.

What is a Neurologist?

A neurologist is a physician who has specialized training and education in diagnosing and treating conditions related to the brain, spinal cord, and peripheral nervous system. These specialists use electrodiagnostic testing and various imaging techniques to help them diagnose any given condition.

Some of these techniques include:

Electroencephalogram (EEG)

Evoked Potentials

Magnetoencephalogram (MEG)

Computed Tomography Scan (CT or CAT Scan)

Positron Emission Tomography (PET)

Magnetic Resonance Imaging (MRI)


Lumbar Puncture (LP)

Electromyogram (EMG)

Nerve Conduction Studies (NCS)

Spinal Tap (also known as Lumbar Puncture)

Once a Neurologist has made his diagnosis, he may then refer you to a Physiatrist. A physiatrist is a rehabilitation specialist that will help you manage your condition through medication, proper diet, and physical therapy.

Sources & references used in this article:

Differential effects of fingolimod (FTY720) on immune cells in the CSF and blood of patients with MS by MC Kowarik, HL Pellkofer, S Cepok, T Korn, T Kümpfel… – Neurology, 2011 – AAN Enterprises

Humoral CSF parameters in the differential diagnosis of hematologic CNS neoplasia by M Weller, A Stevens, N Sommer… – Acta neurologica …, 1992 – Wiley Online Library

Multivariate approach to differential diagnosis of acute meningitis by B Hoen, JF Viel, C Paquot, A Gerard… – European Journal of …, 1995 – Springer

MicroRNAs in Alzheimer’s disease: differential expression in hippocampus and cell-free cerebrospinal fluid by M Müller, HB Kuiperij, JA Claassen, B Küsters… – Neurobiology of …, 2014 – Elsevier

Differential diagnosis of acute meningitis: an analysis of the predictive value of initial observations by A Spanos, FE Harrell, DT Durack – Jama, 1989 – jamanetwork.com

A modern approach to CSF analysis: pathophysiology, clinical application, proof of concept and laboratory reporting by A Regeniter, J Kuhle, M Mehling, H Möller… – Clinical neurology and …, 2009 – Elsevier

Occurrence of periodic oscillations in the differential blood counts of congenital, idiopathic, and cyclical neutropenic patients before and during treatment with G-CSF by C Haurie, DC Dale, MC Mackey – Experimental Hematology, 1999 – Elsevier