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Lumbar puncture procedures

Hi All,

I have a LP on Monday - just wondering if anyone can help prepare (laughable I know!) me for what’s ahead? I.e how long ill be kept in after, after care, how much bloody pain I am going to be in?! Bit clueless about it all really :frowning: TIA Helen

Hi, people here tell different stories about their LP procedure.

I`ve had 2 and didnt enjoy either!

You do need to lie down for about 4 hours after.

I had no after effects.

It has to be done, so lie back and think of England!

pollsx

Hi Polls,

Thanks for commenting :slight_smile:

From what ive been told im not expecting to enjoy it either lol! Just trying to work out when they will kick me out and if there is anything I should do afterwards? I will do my best to kick back and enjoy the rest! Should be fun :frowning:

Helen x

Hi,

The actual procedure is not painful; in fact the only thing you feel is a scratch when the anaesthetic goes in. The actual removal of fluid is just a feeling of pressure if done properly. I must stress if done properly; do not let anyone practice on you insist on someone who is experienced.

It’s after you MAY get something called ‘the headache from hell.’ To cut down the chances of getting this you should lay flat for at least 3 hours do not even get up to go to the loo; use a pan. Drink at least 2 litres of classic Coke, not diet; it’s the caffeine that aids replenishment of your CNS fluid. Being your drinking a lot take one of those bendy straws otherwise the bed will get more Coke than you. If you want a change of drink very strong coffee.

These things will drastically reduce your chances of getting a headache that could last about 8 days. If you have a couple of days off work and rest if you do not get the headache, if you do 10 days off work.

If the headache lasts more than 10 days you could need a blood patch; especially if there’s a wet patch on the bed in the area of the spine after a night’s sleep; this is rare.

Good luck.

George

If you search this site, there are loads of threads giving good advice about having an LP.

Basically, wear something loose and comfortable so that the doctor can easily access the small of your back. You lie on your side with your knees drawn up (if you can) whilst the test is done and you will be told to remain lying it that position for some time afterwards - which was a bit uncomfortable for me!

You have a local anaesthetic in the area before they do the actual LP and for many people (me included) this is the most painful part of the process. I won’t lie to you - some people do find it painful but many, many, many people find that the anticipation is far worse than the reality.

Some people do get a headache after the LP. You are advised to keep yourself hydrated with high sugar/high caffeine drinks - ie Coke or Pepsi (not diet). Take some with you to drink whilst you are lying down but remember to take a straw so you don’t spill it all over you.

1 Like

I’ve had two lumbar punctures…the first one when I was 20 (WAY back in 1980) in those days they kept you in hospital, lying flat for 24 hours after the procedure. The procedure itself was uncomfortable but no worse than that. 24 hours later I went home with no issues whatsoever.

The second one was last year - they tell you to lie flat for 4 hours after the procedure. Again the procedure itself was uncomfortable, but no worse. I stayed flat for 4 hours and then went home. The following morning - while I was sat watching breakfast TV I started with the ‘headache from hell’. (by the way this completely goes away if you lie flat again)

The headache lasted for a good few days and i’m convinced that if i’d lain flat for as long as possible after the LP that I wouldn’t have had the headache.

So to get to the point … lie flat for as long as you possibly can after it. The procedure - if done by an experienced doctor - is really and truly nothing to worry about.

Good luck

Juls

Different hospitals will have different procedures for how long you are “kept flat” after an LP. I was only kept flat on the bed for about an hour. You will be a patient on a day ward so you will be monitored and checked for any side effects of the LP (VERY thoroughly indeed on my experience!)

If I had been forced to use a bedpan there would have been ructions, I can tell you!

I have had two lumber punctures as well only felt a tingle type sensation when the needle hit the spot was up after a few minutes and told to take plenty caffeine so coffee and cola didn’t have a headache or sore back results took about two days iff I remember correctly. I was a in patient both times .

My own experience of this procedure was much better than I thought. The only thing I felt was first local jab in my back, after the procedure I had to rest for a short while and after having something to eat was allowed to go home. Good luck

According to the Barts Blog asking for a atraumatic needle will greatly reduce risk of headache.

http://www.clinicspeak.com/lumbar-puncture/#0/0

Well I had the lumbar puncture done and it hurt like hell but no headache :slight_smile: Luckily the results have come back and no evidence has been found to support MS. This is two fold - was hoping something would show so that I could get a diagnosis at last but now I am unsure. Does a LP always confirm a MS diagnosis? Cheers Hx

hiya helen

i didnt have a lumbar puncture and have been diagnosed 12 yrs.

as person above says-its just another part of the puzzle.

ellie

Helen… have you had an MRI already? That’s good news about your lumbar puncture results. Good reason to be positive.

I have Cherry :slight_smile: had one back last Nov and one a couple of weeks ago. A couple of lesions were obvious on the first one but havent had the results on the second one yet. Will have to wait until Sept to see my neurologist. Thank you all for responding :slight_smile: xxx

Spinal Tap

A spinal tap (also known as a lumbar puncture) is a procedure whereby a sample of cerebrospinal fluid (CSF) is taken from close to the spinal cord. At the same time a blood sample is taken usually from the arm and a quantity of blood serum is isolated. Both of these samples are then processed using a technique called electrophoresis. A positive spinal tap will produce oligoclonal bands in the CSF but not in the blood serum. These bands indicate a type of immune system activity. Although uncomfortable, the spinal tap itself is often not too painful, whereas in the period following the tap, the patient may experience dizziness, nausea, vomiting and severe headaches, occasionally for as much as a week. There are a few rare but serious side-effects of spinal taps. For more information about spinal taps and how to reduce the possibility of some of the more unpleasant side-effects follow this link: Spinal Tap.

95% of people with a definite diagnosis of MS exhibit oligoclonal bands on a spinal tap. This may sound impressive but so do 90% of people with Sub-Acute Sclerosing Panencephalitis and 100% of people with Herpes Simplex Encephalitis among other conditions. Positive spinal taps are indicative of an immunological response but they are not diagnostic for a particular condition. That 5% of PwMS do not exhibit oligoclonal banding means that spinal taps neither rule-in nor rule-out MS.

The primary purpose of CSF analysis should be to rule out other conditions than multiple sclerosis. Although they can be highly suggestive of MS, they do not, in themselves, provide definitive disgnosis. Indeed, I myself, was given a definite diagnosis based on medical history, clinical examination, MRI and evoked potential tests - I declined to have a spinal tap.

Before MRI, electrophoresis of spinal fluid played a major role in supporting diagnoses and underpinned the Poser criteria. Now, however, these criteria have become overshadowed by MRI and, if an MRI is positive, the new diagnostic criteria (2001)allow for a definitive diagnosis without laboratory support. The old “Laboratory supported Definite MS” has been dispensed with.

However, CSF analysis technology is still advancing and researchers continue to look for definitive molecular markers of MS. Should they find such a marker, spinal taps will reassume their importance. Other researchers are looking into urine and blood for markers and we can hope that they are successful and spinal taps become completely unnecessary to the diagnosis of multiple sclerosis.

Hi Helen,