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Lumbar puncture

Lumbar Puncture or Spinal Tap

This is a test during which a special, thin needle is inserted into the space that surrounds the spinal cord in the lower back. The fluid that bathes and protects the brain and spine is called cerebral spinal fluid (CSF).

How is a lumbar puncture done?

Patients should ask for specific information in regards to preparation for a lumbar puncture or spinal tap from their doctor.

In children, a lumbar puncture is usually done with them lying on their side with their knees pulled up to the chest. This helps to spread the bones of the spinal column of the lower back apart, giving the person performing the test a larger area into which to put the needle. This area of the skin is cleaned and a small amount of "freezing" medication is inserted by needle to give a numbing effect. Some patients say they experience a burning sensation for a few seconds while this is being done.

Then the special, thin needle is inserted just below the spinal cord to avoid spinal cord injury. Some patients say that they feel a pushing or pulling sensation at this time. Once in this correct space, a sample of CSF is collected. When the test is over, a bandage is put over the area. The patient is usually instructed to lay flat for several hours in order to avoid getting a headache.

How is this information helpful to my doctor and I?

In patients with demyelination CSF is drawn in order to:

  1. Rule out infection
  2. Check if Oligoclonal Bands (OCB) are present in the spinal fluid. Positive OCB is associated with Multiple Sclerosis in adults, but the role and importance of OCBs in children with demyelination is not known. These results may be helpful in the future with more research.
  3. Perform Metabolic Studies: CSF can be studied to evaluate metabolic (energy-related) pathways in the brain. These are not required for all children - your doctor will decide; some children will have these studies ordered due to specific symptoms.