Lumbar puncture (LP): indications and precautions
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Lumbar puncture (LP): indications and precautions. Central nervous system (CNS) infections, CNS autoimmune disease. Fully referenced neurology checklist.
Diagnostic indications
- Central nervous system (CNS) infections
- CNS autoimmune disease
- Primary CNS vasculitis
- Neuro-inflammatory disorders
- Inflammatory peripheral neuropathies
- Idiopathic intracranial hypertension (IIH)
- Subarachnoid haemorrhage
- Neoplastic meningeal disease
- Dementia
- Normal pressure hydrocephalus (NPH)
- Detecting CSF leaks: with Fluorescin
Therapeutic indications
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Indications for head CT before lumbar puncture (LP)
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Absolute contraindications
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Relative contraindications
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Antiplatelet precautions
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Anticoagulant precautions
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References
- Costerus JM, Brouwer MC, van de Beek D. Technological advances and changing indications for lumbar puncture in neurological disorders. Lancet Neurol 2018; 17:268-278.
- Wright BLC, Lai JTF, Sinclair AJ. Cerebrospinal fluid and lumbar puncture: a practical review. J Neurol 2012; 259:1530-1545.
- Tunkel AR, Hartman BJ, Kaufman BA, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004; 39:1267-1284.
- Engelborghs S, Niemantsverdriet E, Struyfs H, et al. Consensus guidelines for lumbar puncture in patients with neurological diseases. Alzheimers Dement (Amst) 2017; 8:111-126.
- Chaudhuri A, Martin PM, Kennedy PGE, et al. EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults. Eur J Neurol 2008; 15:649-659.
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