Department of Neurology Information for Lumbar Puncture Potential candidate for Lumbar Puncture What is a Lumbar Puncture? Lumbar Puncture is when a thin needle is inserted into your back (i.e. between the bones in your lower spine). It is done under local anaesthesia, so the procedure is pain-free. However, some patients can suffer from post-lumbar puncture headache and/or back pain for a few days. Who will perform the Lumbar Puncture? It is carried out in the hospital by an appropriately trained health care professional (either a doctor or nurse). Why is a lumbar Puncture needed? 1) Diagnostic Lumbar Puncture is the way of testing the CSF ( i.e: the fluid which is circulated between brain and spinal cord). For instance, to confirm diagnosis of Multiple Sclerosis (MS), infection (meningitis, encephalitis), and other neurological conditions. 2) Therapeutic taking fluid out to treat certain conditions (Benign intracranial hypertension). Prior to the Lumbar Puncture An MRI scan or CT scan are sometimes requested before the procedure to make sure there is no contraindication for the lumbar puncture. Blood samples are taken before the procedure. Please inform the doctors if you are on blood thinning medications (such as dabigatran etexilate, rivaroxaban, apixaban, edoxaban, or heparin, anti-platelet drugs like Aspirin, clopidogrel and dipyridamole). You also need to inform the doctors if you are seeing a haematologist or GP for any blood disorders. Information for Lumbar Puncture Page 1 of 5
On the day of the procedure 1) You can eat and drink normally. 2) Take all regular medications apart from blood thinning medications. 3) Doctors will explain the procedure. 4) You will be asked to sign the consent form. 5) Please make sure you empty your bladder before the procedure so that you are not uncomfortable during it. What happens during a Lumbar Puncture? The lumbar puncture takes 30-45 minutes: 1) You will either be asked to lie on your side with your knees curled up to your stomach (baby position) or asked to sit on the side of the bed, bending forward. 2) Your lower back is cleaned with disinfectant. 3) You will then be given a local anaesthetic injection to numb the area. This may sting for a few seconds. 4) Doctors will carefully insert a needle into a space in the lower back, below where the spinal cord ends. You will need to hold very still so that the needle does not move. You may feel some pushing as the needle enters your back, please tell your doctor if you feel pain. 5) A sample of your spinal fluid is then taken and will be sent to the laboratory for testing. 6) A small dressing will then be put on your back. 7) Blood may be taken after the procedure as required. After your Lumbar Puncture You will be asked to lie flat for an hour after your lumbar puncture and after that you will be free to go home. Information for Lumbar Puncture Page 2 of 5
Do not drive on the day of lumbar puncture, please bring someone with you who can drive. Complications of Lumbar Puncture 1) Post-lumbar puncture headache, the onset can be variable and last for up to a week you will be given pain killers at the hospital if you need them. 2) Swelling and lower back pain where the needle is inserted- it will get better with time. Difficulty performing the procedure The likelihood of a difficult lumbar puncture is 1 in 20 patients, especially when patients have certain conditions such as severe arthritis of the spine, abnormally shaped spine or if they are overweight. In these situations, the procedure may be performed under X-Ray guidance. Following your Lumbar Puncture While recovering from a lumbar Puncture, Do 1. Drink plenty of fluids 2. Take pain killers, such as paracetamol. 3. Remove the dressing or plaster yourself after 24 hours. Don t 1. Drive or operate machinery for at least 24 hours. 2. Play sport or do any strenuous activities for at least a week. Information for Lumbar Puncture Page 3 of 5
Seek immediate attention from the hospital 1) If the headache becomes very severe or doesn t go way 2) If you develop a fever and/or continuous vomiting. 3) If your eyes become sensitive to light. 4) Swelling at the site of the Lumbar Puncture which becomes worse 5) Blood or clear Fluid leaking from the back. If you have any questions, please do not hesitate to ask doctors/nurses before the procedure. Useful further reading; NHS Choices Lumber Puncture www.nhs.uk/conditions/lumbar-puncture/ Last access 12/03/2018 References 1). www.hey.nhs.uk/patient-leaflet/lumbar-puncture/ 2). www.patient.info/doctor/lumbar-puncture-pro Information for Lumbar Puncture Page 4 of 5
Contacts / Further Information If you would like further information, regarding the content printed in this leaflet please contact the Department of Neurology via switchboard on 01245 362000. Please ask if you require this information in other languages, large print, easy read accessible information, audio/visual, signing, pictorial and change picture bank forma via the Patient Advisory Liaison Service (PALS) on (01245) 514235. Mid Essex Hospital services NHS Trust is smoke-free. You cannot smoke on site. For advice on quitting, contact your GP or the NHS smoking helpline free, 0800 169 0 169 Charitable donations can make a very real difference to the level of patient care at our Trust. As well as contributing to new facilities, donations can be used to buy specialist equipment and smaller items to make patient s stay in hospital more comfortable. For information about making a donation please contact the Charities Office on 01245 514559 or visit the website at: http://www.meht.nhs.uk/our-charity/ Document History Department Department of Neurology Published/Review: April 2018 / March 2021 File name Information for Lumbar Puncture Version/ref no 1.0 / MEHT170034 Information for Lumbar Puncture Page 5 of 5