Biochemical Marker OCBs and IgG index roles in the Diagnosis of Multiple Sclerosis at Ali Omar Askar Hospital, Libya 2025

Abstract

Multiple sclerosis (MS) is a chronic autoimmune inflammatory disorder affecting the central nervous system and represents a leading cause of neurological disability in young adults. This retrospective study evaluated the diagnostic value of cerebrospinal fluid (CSF) oligoclonal bands (OCBs) and IgG index in suspected MS patients attending Ali Omar Askar Hospital, Tripoli, Libya, between January and October 2025. A total of 460 clinically suspected patients were assessed using the 2017 McDonald criteria, incorporating magnetic resonance imaging (MRI), CSF OCB analysis, and IgG index measurement. Results showed that 337 patients (73.3%) were confirmed as MS cases, while 123 patients (26.7%) were classified as non-MS neurological disorders. Positive OCBs with elevated IgG index were strongly associated with confirmed MS diagnosis. Female predominance was observed, with 253 females (75.1%) and 84 males (24.9%), giving a female-to-male ratio of approximately 3:1. Monthly variation in case distribution was statistically significant (χ² = 43.62, p < 0.001). These findings support the important diagnostic role of CSF biomarkers, particularly OCBs and IgG index, when combined with MRI and clinical evaluation. The study also demonstrates that Libyan MS patients exhibit epidemiological patterns similar to global populations. Expanding access to CSF testing and MRI may improve early diagnosis and patient outcomes in Libya.