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spinal tap
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spinal tap

My neurologist wants to do a tap, just in case to look for stuff like lyme, ms, ect.

Me, 25 male. left sided facial numbness (mild) started 2.5 years ago. Normal MRI-MRA

2 months ago, daily headaches, light sensativity, some mild vertigo came on.

I had a MRI-MRA exactly one month ago, that was NORMAL.

Had, an eye exam this week. Looked good, no inflmation on slit lamp, or on dilation.

Tap, is for next week.

Is this safe? I just dont want to have Increased Pressure or something like that, then get the tap done as that could be dangerous.

does it hurt? they said they are using xray guidance

Thanks
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11 Comments Post a Comment
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Avatar_m_tn
Hi
It is unconfortable but does not take long
Remember to lie down afterwards for a couple of hours or else you may get a terrible headache
good luck

regard
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572651_tn?1333939396
For most people, the thought of a spinal tap (aka lumbar puncture) is so much worse than the actual procedure.  Under the hands of a skilled person, you should have little discomfort and as John said, rest afterwards and drink some extra fluid.    If you want the full details of what a tap is like, I wrote about it in my journal.  I can post that link if you are interested.

welcome to our forum - I'll watch for you around.

Lulu
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Avatar_f_tn
I have a differing opinion; I would avoid a spinal tap.  It does not rule out or rule in MS or Lyme, (in fact only 7 to 10 percent of taps reveal Lyme disease) and a good number of people (myself included) end up with the horrid headache. I was dxed with MS despite a negative spinal tap, so of course I feel it was in vain.

This is just my opinion, and I know others here don't share my view.
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1040373_tn?1273691088
I had an LP with x-ray guidance done on 9/4. What I didn't expect was that you lie flat on your stomach for it. Of course you know there are needles involved with the numbing and fluid extraction so there will be some discomfort. But luckily for me, the nurses and the tech who collected the sample were SO NICE and they made me as comfortable as they could.

I was told this procedure is completely safe. The fluid is collected below where the spinal cord ends and they let the fluid drip out on its own using its normal pressure - they don't force it out. This is supposed to help your body better adjust to the fluid loss I think.

Please don't be afraid. It is not that bad and you WILL be okay. I would recommend taking it easy the next day as well. I exterted myself too much because I felt up to it and I got a seriously annoying headache.  

I'm curious as to why your doc is ordering an LP though if you MRI didn't suggest something like MS. Have they done bloodwork yet to rule out lyme, HIV, vitamin B deficiency etc?

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572651_tn?1333939396
Amyloo is right, the LP does not confirm or rule out MS and is just one of many diagnostic aids that can be used to shape the bigger picture as to whether you have ms or not.  It is not used as much as it used to be, and there are some neuros who don't do it at all.

About one if 7 LP patients end up with a headache from the procedure and leaking fluid.  

Here is where I wrote about my experiences with the LP - I hope it helps to answer your questions and concerns.

http://www.medhelp.org/user_journals/show/42150?personal_page_id=5829
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1012981_tn?1322606893
I agree with Amyloo, one of my LP's did not go well and i had lower back pain for about 3 weeks. I will NOT have a lumbar puncture again! Besides the test can be negative and you can still have MS.

Bob :)
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667078_tn?1316004535
It is an individual decision. Mine went fine. I did get the headache. I am glad I had mine because it did give me my diagnosis sooner than later. My doctor is very conservative about Lumbar Punctures.

Alex
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867582_tn?1311630997
Hey motox,

Usually I come on very strong against spinal taps, but in your case, since everything else is negative, it might be revealing as to what is causing your symptoms.

However, because of my own horrendous experience with spinal tap (done using fluoroscopy)  resulting in an excruciating electric jolt going down my right leg at one point during the procedure and an eventual spinal fluid leak requiring blood patch, I cannot ever recommend spinal tap to anyone, no matter what!

I will never, ever have another spinal tap.  However, some people have no problem whatsoever with spinal tap while others do have problems - some much worse than mine.  In fact, some people have residual damage from the procedure that never goes away.  You just don't know which group you'll be in.  I think a lot depends on who does the spinal tap, the luck of the draw.  At first my MD was just going to have his PA do it on me, but I made the mistake of insisting on the MD's doing it.  The rest is history.  Thankfully, I have no residual damage at least, just horrendous memories of it.

This much is certain, regarding spinal tap, the idea that "this procedure is completely safe" is totally erroneous!  Spinal tap, like any other invasive procedure on the body involves risk:  The possibility of infection, among other things.  

Since you're not sure about the tap, why don't you put it off a bit?  Were your MRIs done on 3 Tesla?  That can make a difference.  Also, did you have spinal MRIs as well as brain MRI?  Have you had evoked potentials yet?

Also, have you had the blood test for Lymes?  That's a lot simpler than a spinal tap.

Why don't you give yourself the old heat test that doctors used to use eons ago before they had MRIs to play with.  What happens to you when you get really hot in some damp heat - like a sauna?  Do you notice your vision blurring, your foot dragging a little afterward?  That used to be considered a major indicator of MS because, from what I read, no other disease responds to heat in that way.

Anyway, I hope I gave you the total scoop on spinal tap:  It may end up being a totally benign experience for you . . . or it may not.

Good luck!

WAF
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572651_tn?1333939396

Absolutely DO NOT DO THE OLD HEAT TEST - there is a reason why doctors don't do this any more.... it is DANGEROUS and can cause symptoms to turn into PERMANENT DAMAGE.

Yes, I am yelling this advice.  Don't go messing around and taking this kind of chance.


We have one member here, Sarahmoms, who incurred long lasting damage, because she didn't think sitting in a hot tub would be a big deal - she found out how wrong that thinking was.


Please, please do not ever expose yourself unnecessarily to excess heat.  

Lulu
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667078_tn?1316004535
I am glad when I was going for my LP there were people on the forum  like Lulu,who did not scare me half to death. I was already nervous. There are risks with ANY medical procedure. Doctors would not do these tests if there was another way to get the information. If you should decide to have the LP we are there for you as we are if you decide not to.

Alex

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147426_tn?1317269232
I have to counter the remark that the LP causes some to have lasting damage.  This is very, very rare.  Yes, an LP can cause nerve shocks when a nerve is trapped by the needle.  While this can be painful, it is temporary.  The headache is a pain which may last days to weeks.

Everyday in this country thousands of LPs are done.  The great majority of them are without any problem whatsoever.  I, myself, have performed several hundred and have never had a bad outcome.

I understand WAF's fear of having another.  The CSF leak headache is terrible, but you get over it.  If the diagnosis of a disease that can possibly be helped by meds requires an LP, then I feel it is worth the risk.  WAF is well with her rights to refuse another.

Deep down there is a fear that LPs cause paralysis and occasionally death.  This is a myth which began long, long ago when spinal taps were done to diagnose polio and meningitis (which was quite frequent then).  Then the person often had the disease and ended up paralyzed.  Polio and meningitis cause paralysis.  The families came to the conclusion that the LP, which looked so frightening, caused the paralysis.  This myth and fear of spinal taps was common when I first began in medicine in the 70's.  The fear people have about it seems almost primal.

It is true that if a person already has increased intracranial pressure an LP can cause death.  There are plenty of signs on exam, vital signs and the MRI that a person has increased intracranial pressure (like a brain tumor might cause).  This should never be a risk in the diagnosis of MS where an MRI is one of the first tests, always before an LP.  
So, this should not be a concern.

You can always refuse a tap.  But, I have never heard anyone in medicine or on this forum state that a tap is completely safe.  Heck, having your blood drawn is not "completely safe!"  You can always bleed or have painful bruises or introduce infection.  The vast majority of people who have taps have no problems.  And the people who do have problems are more likely to talk about it than those who had no problems at all and are going about their lives.

Also, I agree with Lulu about willfully getting yourself overheated.  Yes, it was used as a diagnostic test years ago.  However, after reports of causing permanent paralysis, it was not used anymore.  Sarahsmom showed us all with the hottub incident that it can have terrible consequences.

My own personal experience is three LPs without a problem except for some localized spasm and soreness at the tap site.  The post-LP headache I had does not count as it was the result of a botched epidural anesthesia (9 attempts) then a spinal anesthesia.  Yes, that was a horror for me.  But, the three simple spinal taps afterward were a breeze for me.

Also it is a myth that the needle in the tap could hit the spinal cord and damage it.  The cord ENDS above where they do the tap.

Quix
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