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Lumber Puncture

Hello everyone! I was looking for a wee bit of advice and reassurance. My neurologist has referred me on to the MS team after an MRI on my brain showed scarring and he also took blood tests. He mentioned the possibility of needing a lumbar puncture too and the mere thought of this frightens me beyond belief. I was wondering if a lumbar puncture is necessary for everyone and if it is would they carry it out under general anaesthetic rather than a local if I explained how distressed I would become. The sheer prospect of having one makes me want to start crying so goodness knows what state I’d be in on the day of the procedure! Thanks Claire

Hi Claire,

A lumbar puncture is not strictly nesacerry for diagnosing MS, although it can help speed the process up. I’m not sure if they would do it under GA as it is a day procedure usually, but if you are really concernd it wouldn’t hurt to ask? I had one and was dreading it, however it turned out my fear was greater than the reality. Didn’t cause any pain and I was home within 4 hours. Have a chat with your team and see what they suggest and remeber if you really don’t want it they can’t make you.

Best of luck

Laura x

The thing with a lp is that the thought of it is generally worse than the actual procedure itself. One bit of advice I have is to try not to think about it (I know it’s easier said than done) but the more you stress and get worked up about it the more nervous you’ll become and honesty it’s not as bad as you might think!

You poor love! Had mine about 8 weeks ago. It’s not pleasant I won’t lie but you’ll get through it. I’m not sure GA is applicable as they need to get you in the right position and mightn’t be possible if you’re knocked out. You’ll be fine! I didn’t realize the headache you could have afterwards as mine didn’t come on for many hours. It lasted 6 days so I took advantage of the lying flat, got spoilt and watched lots of internet TV.

You poor love! Had mine about 8 weeks ago. It’s not pleasant I won’t lie but you’ll get through it. I’m not sure GA is applicable as they need to get you in the right position and mightn’t be possible if you’re knocked out. You’ll be fine! I didn’t realize the headache you could have afterwards as mine didn’t come on for many hours. It lasted 6 days so I took advantage of the lying flat, got spoilt and watched lots of internet TV.

To try and avoid the headache I took a 2 litre bottle of full fat coke and a straw and drank as much as possible and had no headache after the lp. The caffeine helps replenish the csf that they remove with the lp (cerebral spinal fluid).

I was diagnosed on 2 MRIs only and clinical history, so no a LP is not necessary in all cases

I’ve had 2 MRI’s without contrast done but they have been clear although my neurologist really does think I have M.S from neurological examination and history. I’m being referred to a M.S specialist and I am severly needlephobic. I believe that if a L.P is completely necessary the neurologist has asked for them to perform it under a general anesthetic for me because I’ve been refusing to have it done for the past 4 years otherwise.

I’ve had 2 MRI’s without contrast done but they have been clear although my neurologist really does think I have M.S from neurological examination and history. I’m being referred to a M.S specialist and I am severly needlephobic. I believe that if a L.P is completely necessary the neurologist has asked for them to perform it under a general anesthetic for me because I’ve been refusing to have it done for the past 4 years otherwise.

Hi Claire I was diagnosed without a LP. I had enough change in my MRI scans to be diagnosed without it. I had also mentioned that the thought of having a LP was a nightmare. It may be worth asking the question and seeing if you can get away with not having it x

Thanks so much for your support everybody! I’ve been trying my best not to catastrophise too much about it as it is for my own good after all. People have been telling me not too be silly because if I can sit for hours being tattooed then a 45 minute procedure shouldn’t be too much of an ordeal. Suppose they have a point! Hope you are all keeping well, it’s great being able to talk to others! Claire xXx

Hi Claire,

Bit late to this discussion, but I was diagnosed without one, if that’s any help, because I declined to have it.

I don’t consider I was “being silly”: how you feel is how you feel, and one of the things that influenced me was it wasn’t guaranteed to to move the investigation any further. If it had been abnormal, it would have strongly supported a diagnosis of MS, but if it had been normal, it wouldn’t have helped either way, as a small proportion of people with MS still have a normal LP, so it couldn’t prove I didn’t have it.

As others have suggested, I think it probably did make my diagnosis take a little longer than it otherwise might, but that’s assuming I would have got positive results. If the results had been negative, it wouldn’t have made any difference timewise at all.

Either way, I’m living proof you can be diagnosed without one.

The NICE guidelines are in fact worded along the lines that lumbar puncture should now be the exception, rather than the rule, but the overwhelming majority of neuros still seem to prefer one. I guess that stems back to the days when MRI imaging was still in its infancy - old habits die hard!

Tina

x

Thanks for getting back to me Tina and that’s really reassuring to know that LPs are not always an absolute necessity. Even if the diagnosis was to take a wee bit longer I’ve already lived with my symptoms for over a year and a half now so a couple months aren’t going to do me much harm. The hospital haven’t really been the most efficient either do I’d have a wait regardless. It’s an expensive procedure for the NHS to do so I’m also surprised that some Neuros still push for it! Claire xXx

[quote=“rufus”]

I was diagnosed on 2 MRIs only and clinical history, so no a LP is not necessary in all cases

[/quote] I too have been diagnosed without. Lumba puncture although initially was told I would need one by another consultant not my neuro! My positive mri of my brain alone and my medical history were enough to diagnose me!

Cheers Princess! Got a call from the hospital today to ask me to come in on Monday evening for a spinal MRI. Maybe that’ll be evidence enough! xXx