CSF-VDRL test
Definition
The CSF-VDRL test is used to diagnose neurosyphilis. This test looks for antibodies called reagins, which are sometimes produced by the body in reaction to the syphilis-causing bacteria.
See also: VDRL
Alternative Names
Venereal disease research laboratory slide test - CSF
How the Test is Performed
The test is performed on a CSF sample obtained by lumbar puncture (spinal tap).
How to Prepare for the Test
Before the procedure, you will be asked to review the risks and sign a consent form.
How the Test Will Feel
Usually, discomfort associated with the lumbar puncture is mild to moderate. The entire procedure usually takes about 30 minutes but may take longer. The actual fluid collection only takes a few minutes.
Why the Test is Performed
The CSF-VDRL test is used to diagnose syphilis in the brain or spinal cord. Brain and spinal cord involvement usually indicates late stage (tertiary) syphilis.
Blood screening tests, such as VDRL and RPR, are more effective during middle stage (secondary) syphilis.
Normal Results
A negative result is normal.
However, false-negatives can occur. This means you can have syphilis and have a normal CSF-VDRL test result. Therefore, a negative test does not always rule out the disease. Other markers of inflammation, such as elevated protein levels or excess white blood cells, may be used to diagnose neurosyphilis.
What Abnormal Results Mean
A positive result is abnormal and indicates neurosyphilis.
Risks
Risks of lumbar puncture include:
- Hypersensitivity (allergic) reaction to the anesthetic
- Discomfort during the test
- Headache after the test
- Bleeding into the spinal canal
- Brain herniation (if performed on a person with increased intracranial pressure) which may result in brain damage or death
- Damage to the spinal cord or nerve roots
References
Hook EW III. Syphilis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 340.
Fletcher JJ, Nathan BR. Cerebrospinal fluid and intracranial pressure. In: Goetz, CG, eds. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 26.
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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