Lumbar Puncture In Children

WHAT YOU SHOULD KNOW:

• Lumbar puncture, also called LP, is a procedure where a needle is inserted in your child's back and into his spinal canal. This may be done to collect cerebrospinal fluid (CSF) or treat certain medical conditions. The spinal canal contains the spinal cord, which carries messages between your brain and your body, and CSF. CSF is a clear fluid that flows around the brain and inside the spinal canal. This fluid contains information about body functions and disease processes. It also acts as a cushion to protect the brain and spinal cord from injury. LP may be used to check for an infection, inflammation (swelling), or other conditions affecting the brain. Your child cannot have an LP if he has increased pressure in his brain. The increased pressure may be caused by a tumor or blockage. If your child bleeds easily or an infection is present in the area where the needle will be inserted, a LP is not done.
  
  
• During a lumbar puncture, CSF may be collected and sent to a lab for tests. The tests check for changes in the CSF, including the presence of blood, protein, glucose (sugar), and germs. The sample may also be used to do certain tests that check for an infection. Sometimes, medicine may be put through the LP into your child's back to treat a disease. CSF pressure may also be measured during LP.

INSTRUCTIONS:

Medicines:

• Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  
  
• Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  
  
• Antinausea medicine: This medicine may be given to calm your child's stomach and control vomiting (throwing up).

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.

• Ask your caregiver when the results of your child's procedure will be available.
  
  

Post-lumbar puncture headache:

Your child may develop a headache during the first few hours after his LP, which may last up to several days. This happens when the amount of CSF and the CSF pressure are decreased, such as with a CSF leak. The headache may range from mild to severe (very bad) and may get worse when he sits or stands. He may have a headache that gets worse when he sits or stands. He may have neck or back pain, feel sick to his stomach or vomit (throw up). He may have problems with his sight and hearing, such as blurred or double vision, dizziness, and ringing in his ears. The following may help ease or prevent a post-lumbar puncture headache:

• Drinking liquids: Your child may be asked to drink more liquid than usual after his LP. For most people, good liquids to drink include water, milk, and juices. Tell your child's caregiver if he cannot drink a lot of liquid because of another medical condition, such as a heart or kidney condition.
  
  
• Lying down: Your child may need to lie flat for some time after his LP. Ask your child's caregiver how long he needs to lie down.
  
  
• Treatment options: Your child may have any of the following:
  
  
  • Medicines:
    
    
    • Caffeine: Caffeine may be used to treat a LP headache. As CSF pressure decreases, such as with a leak, blood vessels in the brain will dilate (get bigger) to get more fluid to the brain. Headache pain is caused by the blood vessels getting bigger. Caffeine causes the blood vessels in the brain to narrow (get smaller), which will decrease your child's headache pain. Have your child drink caffeinated drinks, such as soda, every 4 to 6 hours. If this does not relieve your child's headache, call your caregiver. Your child may need to be given caffeine intravenously (IV) through a tube placed in his vein.
      
      
    • Pain medicine: Your child may need medicine to relieve or decrease his headache pain. These medicines may include NSAIDS (non-steroidal anti-inflammatory medicine), such as ibuprofen, acetaminophen, or medicine that your child's caregiver orders (prescription) for him. Your child's caregiver will decide which medicine is best for your child to take for his headache. Follow the instructions of your child's caregiver on how your child should take his medicine. Tell your child's caregiver if the pain medicine does not help or if you have any questions about your child's medicine.
    
    
  • Procedures: Your child may need to have any of the following if his headache is not relieved by the treatments above:
    
    
    • Blood patch: If your child's headache is caused by a leakage of CSF from the LP site, a blood patch procedure may be needed. This procedure uses a small amount of your child's blood, that is taken from a vein, to patch (seal) the LP leak. The blood is put through a needle into your child's spinal canal in the same way that the LP was done. Your child will need to lie in bed for 1 to 2 hours after this procedure. This procedure may need to be repeated if your child's headache is not relieved.
      
      
    • Saline epidural: A saline epidural may be given if your child's headache is caused by low CSF pressure due to a leak. This procedure puts saline (an IV fluid) back into your child's spinal canal to increase CSF pressure. The increased pressure may help to seal the leak. The saline is put through a needle into your child's spinal canal in the same way that the LP was done.

CONTACT A CAREGIVER IF:

• Your child has a severe (bad) pain in his back or neck.
  
  
• Your child has bleeding or a discharge coming from the area where the needle was put into his back.
  
  
• You have questions or concerns about your child's procedure, medicine, or care.

SEEK CARE IMMEDIATELY IF:

• Your child has a headache that is very bad and does not get better after lying down.
  
  
• Your child has vision (sight) or hearing problems, such as blurred or double vision, dizziness, and ringing in his ears.
  
  
• Your child is sick to his stomach, vomiting (throwing up), or is dizzy.
  
  
• Your child is irritable and crying more than usual.
  
  
• Your child has a fever.
  
  
• Your child has a stiff neck or has trouble thinking clearly.
  
  
• Your child's legs, feet, or other parts below the waist feel numb, tingly, or weak.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.