Domizia Vecchio1, Paola Naldi2, Veronica Ferro2, Cristoforo Comi2, Maurizio Angelo Leone3, Roberto Cantello2. 1. Neurology Unit, Department of Translational Medicine, AOU Maggiore della Carità and University of Piemonte Orientale, Novara, Italy. domizia.vecchio@gmail.com. 2. Neurology Unit, Department of Translational Medicine, AOU Maggiore della Carità and University of Piemonte Orientale, Novara, Italy. 3. Neurology Unit, Department of Medical Sciences, IRCCS, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
Abstract
BACKGROUND: Lumbar puncture (LP) is a safe procedure commonly performed in the diagnostic work-up of multiple sclerosis (MS), and its main adverse event is post-LP headache (PLPH). Predictors for PLPH in MS are not established. AIMS: To describe the occurrence of, and, factors related to PLPH in patients with suspected MS, studied on a daily-basis admission. PATIENTS AND METHODS: One hundred patients (70 females) were admitted for a diagnostic LP (standardized with a traumatic 19-G needle), observed for 6 h, and evaluated for adverse events 2 and 7 days later. Descriptive statistics and a multivariate analysis (for PLPH) were performed. RESULTS: Fifty-seven (57%) patients had PLPH at 48 h, which persisted 1 week in 31, and only two presented beyond the first 2 days. Other adverse events were tinnitus and neck stiffness. None required investigations or was hospitalized. Age was the only predictor for PLPH at day 2, whereas the onset of headache within 48 h and female gender were predictors for PLPH at day 7. CONCLUSION: PLPH is a frequent complication of LP performed on daily-basis admission in MS work-up. The maximum onset is within the first 48 h. Age and gender seem the only predictors for the appearance and persistence of PLPH.
BACKGROUND: Lumbar puncture (LP) is a safe procedure commonly performed in the diagnostic work-up of multiple sclerosis (MS), and its main adverse event is post-LP headache (PLPH). Predictors for PLPH in MS are not established. AIMS: To describe the occurrence of, and, factors related to PLPH in patients with suspected MS, studied on a daily-basis admission. PATIENTS AND METHODS: One hundred patients (70 females) were admitted for a diagnostic LP (standardized with a traumatic 19-G needle), observed for 6 h, and evaluated for adverse events 2 and 7 days later. Descriptive statistics and a multivariate analysis (for PLPH) were performed. RESULTS: Fifty-seven (57%) patients had PLPH at 48 h, which persisted 1 week in 31, and only two presented beyond the first 2 days. Other adverse events were tinnitus and neck stiffness. None required investigations or was hospitalized. Age was the only predictor for PLPH at day 2, whereas the onset of headache within 48 h and female gender were predictors for PLPH at day 7. CONCLUSION: PLPH is a frequent complication of LP performed on daily-basis admission in MS work-up. The maximum onset is within the first 48 h. Age and gender seem the only predictors for the appearance and persistence of PLPH.
Entities:
Keywords:
Diagnostic work up; Headache; Lumbar puncture; Multiple sclerosis
Authors: Ingrid Arevalo-Rodriguez; Luis Muñoz; Natalia Godoy-Casasbuenas; Agustín Ciapponi; Jimmy J Arevalo; Sabine Boogaard; Marta Roqué I Figuls Journal: Cochrane Database Syst Rev Date: 2017-04-07
Authors: Andrés E Monserrate; Davis C Ryman; Shengmei Ma; Chengjie Xiong; James M Noble; John M Ringman; John C Morris; Adrian Danek; Felix Müller-Sarnowski; David B Clifford; Eric M McDade; William S Brooks; David G Darby; Colin L Masters; Philip S J Weston; Martin R Farlow; Neill R Graff-Radford; Stephen P Salloway; Anne M Fagan; Angela Oliver; Randall J Bateman Journal: JAMA Neurol Date: 2015-03 Impact factor: 18.302