Brief Answer:
NAB means your body rejects MS treatment

Detailed Answer:
I read your question carefully and I understand your concern.

NAB in the setting of a MS diagnosis mean neutralizing antibodies. It indicates that your body forms antibodies against interferon which is one of the main drugs used to slow multiple sclerosis progression and as a result the treatment is not effective anymore.
CFS means chronic fatigue syndrome and is usually a component of MS, so in your case it is one of the manifestations of the disease I would say, not a separate entity. MS would explain your balance and coordination problems as well as the fatigue, it is compatible also with the history of paralysis 20 years ago.
As for the tests for MS, MRI of brain and spine is the most important test, if there is doubt other tests include a lumbar puncture to search for oligoclonal bands, a sort of antibody in your cerebrospinal fluid in case of inflammation of the central nervous system due to MS, also some tests measuring the visual and auditory pathways, called evoked potentials.
MS unfortunately is a progressing disease despite treatment disability eventually accumulates over the years, and the presence of NAB is not a good thing regarding treatment efficacy. There are some new treatments other than interferon but they are yet to be proven effective in secondary progressive forms.
As for the diagnosis of Lupus it is a separated diagnosis although both lupus and MS are related to immune system malfunction attacking your own body so they are at times found together in the same patient. Lupus affects many systems in the body including joints and muscles, it can affect nervous system as well so it adds to the disability caused by MS.
Fibromyalgia is a little difficult to be diagnosed in your case as its symptoms of widespread pain and increased sensitivity can also be related to your other conditions and one of the criteria for the diagnosis of fibromyalgia is not having another condition which explains the symptoms.

I remain at your disposal for further questions.

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Brief Answer:
MS diagnosis unclear.

Detailed Answer:
I read your additional info and I also read the previous queries you have submitted to the site. I must confess that I am a little perplexed regarding MS diagnosis. You say in one of your previous queries that you've had no MRI, but if that is the case I don't understand how was a diagnosis of MS made.
There are cases when a doctor is very confident about the diagnosis, but still MRI is performed and your case considering your age is not the most typical one (usually it is diagnosed earlier - even if we take as a starting point your paralysis of 20 years ago).
I assumed that diagnosis was confirmed, and NAB was an additional test, but now that you say never to have taken interferon I am puzzled, actually it's tough to imagine how did they get to the point of testing for something as specialized as neutralizing antibodies without a basic MS test like MRI. I am not aware of any other meaning of positive NAB.
Whether your symptoms could be in the setting of Multiple Sclerosis, yes they could be, causing progressive multiple lesions it can cause the symptoms you mention, but it has to be confirmed with tests and if confirmed receive treatment which you don't seem to be getting. Corticosteroids like Prednisone are used at times, but they produce only a temporary improvement, they do not alter the course of the disease, there are other medical alternatives for that.

So I really think you should have a good talk with the doctor who presented the MS diagnosis to you, as many things don't fit in your diagnostic procedures. If indeed there hasn't been a misunderstanding he should explain how did he make the diagnosis and why the lack of therapy. If it is MS therapy expectations for your age and stage should be discussed with an MS specialist but tough to do without MRI data. It's hard for me to make recommendations on a presumed disease when you haven't had any confirming tests about it.

I remain at your disposal in case you want to add some new info or any other question.

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Brief Answer:
Read below.

Detailed Answer:
I was discussing MS because you had two previous queries where you started by saying that you had secondary progressive MS, with one of them having different questions and answers on that diagnosis, which is a neurological disease. Funny enough that colleague was a rheumatologist.

I notice only now that your question was labelled to rheumatologist, my mistake, I should have paid more attention, but it hasn't happened to me before to receive questions directed to rheumatologists and I clicked to answer. I guess the software recognized the MS text part in your question and automatically directed the question to a neurologist as well.
Since this was my mistake I don't mind if you ask the moderators to take the question from me and give it to a rheumatologist, feel free to ask for that, as I said it is my mistake.

Anyway my opinion is that while some of your symptoms can be caused by the inflammatory arthritis or fibromyalgia, it doesn't explain many other symptoms of yours like double vision, lack of balance, increased reflexes, slurred speech (which you mentioned to my colleague), cognitive impairment etc which as you say have been progressing. These symptoms are more likely to be in the setting of a neurological disorder which can be of several kinds. Multiple sclerosis is one possibility it would explain the symptoms, though not very common at your age. Other possibilities could be repeated strokes or a neurodegenerative disease. A secondary impairment due to a rheumatological disease like lupus, rheumatoid arthritis could be the case as well although my colleague rheumatologist thinks that not to be the cause as you lack other signs.

For each of these possibilities an MRI is necessary in order to confirm or exclude it, so that is what I think should be your next diagnostic step.

As for the tests. I don't know any other use of the term NAB, couldn't find any from a search in internet either. As for the other tests (ESR, C Reactive Protein, alpha globulins), they are not specific, they indicate inflammation but inflammation can have many causes, so they don't make a diagnosis in themselves only support it when there is clinical doubt (usually for rheumatological diseases).

I hope to have been of help.

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Brief Answer:
Read below.

Detailed Answer:
The nuclear antibody test is not denoted by the abbreviation NAB but by the abbreviation ANA (antinuclear antibody), I am pretty sure that is how it's called in US or other English speaking countries as you can check for yourself.
Anyway if ANA is what you are positive for then it's a test used to diagnose autoimmune diseases, mainly rheumatological ones like lupus erythematosus. It's positivity if clinical signs of lupus (or other rheumatological diseases) are present reinforces the diagnosis. If there are no clinical signs though (lupus has other signs in the skin and other organs), as I said you before about those other tests, it doesn't make the diagnosis as it can result positive in a percentage of healthy people as well.

There is no "neurofiltering antibody", I have never heard of it and can't find that term anywhere. Even if it was some new fancy experimental test (but some paper about it would have been published in the net), it wouldn't be the first test to do for MS when you haven't done a basic one like MRI.

As I said before your blood tests indicate that you have a rheumatological disorder as the diagnosis of inflammatory arthritis suggests (though that is a general term not a specific diagnosis, perhaps your doctor meant rheumatoid arthritis?).

Your symptoms go beyond involvement of the joints though, they do indicate an involvement of the central nervous system so you should have a brain MRI scheduled, preferably with contrast, that will give an indication. The MRI 20 years ago is not enough since you have had new symptoms since then.

The ventriculomegaly finding should have had a follow up exam as well. The ventricles are some fluid filled spaces in the brain. Ventriculomegaly means they are slightly enlarged. Might not mean much perhaps born or a remnant of an old infection, but it should have had a follow up imaging test after some time to assess whether there was any progression. So again a MRI is recommended.

Wishing you good health!

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Brief Answer:
Read below.

Detailed Answer:
I imagined that was a misspelling, your difficulties are understandable considering macular degeneration and the multiple conditions you suffer from, I am sorry.

Ventriculomegaly is not a characteristic part of multiple sclerosis (MS), not in early stages when you had that MRI. In MS there are multiple inflammatory lesions in the brain and spine, which cause progressively adding neurological deficits. What is visualized on MRI in MS is small scattered brain lesions. With time these lesions increase and there is also atrophy (loss of brain mass) which can make the ventricles seem enlarged, but that is in advanced cases where plenty of previous lesions would be visible on MRI. So since you describe no such lesions on that old MRI I don't think that mild ventriculomegaly was related to MS, other lesions should have been present.

The causes of ventriculomegaly as I said can be many, many are excluded in your case by the long time since (a tumor or infection would have evolved since) you might have had it since you were born. However a MRI some time after the first is generally indicated to check if there is progression of this ventricle enlargement to exclude conditions like hydrocephalus (build up of too much fluid in your brain). In your case with your balance and coordination issues, speech difficulties etc it makes it even more indicated.

I imagine to a non medical person all this might look confusing at times, I hope to have been understandable.

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Brief Answer:
Thank you!

Detailed Answer:
You have been anything but a pest, actually perhaps it is my fault for not suggesting the possibility of ANA to you, it did cross my mind, it was the combination of MS discussion with NAB - neutralizing antibodies used in MS which made me dismiss it. You doctor should have explained what those antibodies indicated as well.

I hope MRI will reveal no major problems with your brain, you seem to have enough diagnoses as it is.

Thank you for choosing this site for your health related questions.

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