M At The Doctor

Lumbar puncture

Did you watch the TV series "Dr House"? You then saw dozens of lumbar punctures. Shirtless, lying on his side, the doctor pushes a long needle into the back of the patient. With always this little "ouch! "Of circumstance to terrorize the phobic of the needle.

However, the lumbar puncture (PL) is not an examination as terrible as one imagines. Patient management and medical equipment have evolved to limit apprehension and post-puncture pain.

What is lumbar puncture?

Lumbar puncture is a medical procedure that involves taking a little cerebrospinal fluid (CSF) that surrounds the brain and spinal cord. It makes it possible to establish a diagnosis; it can also have a therapeutic aim:

• A diagnosis

The first indication of a lumbar puncture, which is an absolute emergency, is the suspicion of bacterial meningitis. The doctors have 30 minutes to do it after admission to the emergency room.

The second is the intra-cranial hemorrhage. It is confirmed, if at the lumbar puncture, the presence of bleeding blood in the brain is detected.

The third indication of lumbar puncture is Guillain-Barré syndrome, an autoimmune disease that causes reversible paralysis (more or less important) of the limbs and the respiratory system. In this case, there will be a high level of protein and an absence of white blood cells in the CSF.

Note: since the introduction of medical imaging, multiple sclerosis is less and less an indication of lumbar puncture, unless the hospital is not equipped with MRI.

• A treatment

When there is an excess of cerebrospinal fluid because the flow system is no longer functioning properly, lumbar puncture is indicated. In this case, this puncture will be performed to evacuate cerebrospinal fluid in excess, in a specialized environment - neurology, resuscitation or neuro-surgery - once or twice, the time to find the pathology inducing dysfunction.

This examination is usually performed by an emergency physician, a neurologist, a neurosurgeon, a pediatrician ...

Want to react, share your experience or ask a question? Appointment in our FORUMS Osteoarthritis & Rheumatism, Back or A doctor answers you!

Read also :

> Multiple sclerosis (MS)
> Lumbar disc herniation

Author: Nathalie Mathieu.
Expert consultant: Dr. Alex Bucci, geriatrician and former emergency physician, from the Mutual Hospital Group of Grenoble.

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