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What is a lumbar puncture?

A lumbar puncture is a safe, routine and straightforward way of obtaining a sample of cerebro-spinal fluid (CSF). Once the CSF is collected, it will be tested to help diagnose infections that can affect the brain. Your referring doctor will have explained to you the reasons why it is important to have this procedure carried out. The CSF is sent to the laboratory for testing, and the results are usually available a few days afterwards.

How is a lumbar puncture done?

A lumbar puncture will usually be carried out at the Hospital for Tropical Diseases outpatient department. You will always be asked for your consent prior to this procedure. You will be asked to lie on your side. Your skin will be cleaned and local anaesthetic will be applied to numb the area. This may cause a stinging sensation. A very fine needle is inserted into your lower back to obtain the fluid. You may be aware of a pushing sensation at this point but it is unusual for this to cause pain. If it feels too uncomfortable, please tell the doctor.

Occasionally you may be asked to change your position to help with the insertion of the needle. The procedure usually takes 30 minutes in total, although this can vary. You may bring a friend or relative to accompany you if you wish.

After your lumbar puncture

Lie down flat for at least an hour (you will remain in clinic for this time). The doctor will review you after this and advise you when you can go home. Before leaving hospital, get up and walk around to ensure that you are ready for your journey home.

Do not drive for the next 24 hours. Over the next 48 hours, try to drink 3 litres of fluid a day. This helps to reduce the chance of headaches.

Remove the plaster on your back after 24 hours. The iodine used to clean your back will wash away after a few days. Some people experience a headache after a lumbar puncture. You can take paracetamol as long as you are not allergic to this drug. DO NOT take more than 4g (8 tablets) in 24 hours. You may also find it more comfortable to rest on your bed until the headache lessens.

In rare cases the headache can continue for up to 5-10 days following the procedure. If you feel your headache has not lessened during this time, or if you have the following symptoms: 

  • Vomiting
  • Nausea
  • Fever
  • Photophobia (bright lights hurting your eyes)

Please contact the Hospital for Tropical Diseases if you have any questions or concerns Monday to Friday 9am-5pm on 020 3447 5959. If you are a Bloomsbury patient you should contact the Bloomsbury clinic. Out of hours you should contact the Infectious Diseases Registrar via the main switchboard.

Risks

A lumbar puncture is a very safe procedure. It is routinely performed without complication. Before the test you will have been carefully assessed by your doctor. Basic blood tests and a brain scan will have been reviewed. Most people do not experience problems after
a lumbar puncture.

Further information

Have you travelled to a tropical country in the last 6-12 months and are you acutely unwell? You can be seen in our emergency walk-in clinic Monday to Friday 9am-4pm Our travel medicine service offers specialist travel advice including for individuals with complex health conditions. We offer this on a privately and via NHS referral basis. Please contact: uclh.htdadmin@nhs.net or 020 3447 7999 for more information about our services.