Consensus guidelines for lumbar puncture in patients with neurological diseases

Sebastiaan Engelborghs, Ellis Niemantsverdriet, Hanne Struyfs, Kaj Blennow, Raf Brouns, Manuel Comabella, Irena Dujmovic, Wiesje van der Flier, Lutz Frölich, Daniela Galimberti, Sharmilee Gnanapavan, Bernhard Hemmer, Erik Hoff, Jakub Hort, Ellen Iacobaeus, Martin Ingelsson, Frank Jan de Jong, Michael Jonsson, Michael Khalil, Jens KuhleAlberto Lleó, Alexandre de Mendonça, José Luis Molinuevo, Guy Nagels, Claire Paquet, Lucilla Parnetti, Gerwin Roks, Pedro Rosa-Neto, Philip Scheltens, Constance Skårsgard, Erik Stomrud, Hayrettin Tumani, Pieter Jelle Visser, Anders Wallin, Bengt Winblad, Henrik Zetterberg, Flora Duits, Charlotte E. Teunissen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction Cerebrospinal fluid collection by lumbar puncture (LP) is performed in the diagnostic workup of several neurological brain diseases. Reluctance to perform the procedure is among others due to a lack of standards and guidelines to minimize the risk of complications, such as post-LP headache or back pain. Methods We provide consensus guidelines for the LP procedure to minimize the risk of complications. The recommendations are based on (1) data from a large multicenter LP feasibility study (evidence level II-2), (2) systematic literature review on LP needle characteristics and post-LP complications (evidence level II-2), (3) discussion of best practice within the Joint Programme Neurodegenerative Disease Research Biomarkers for Alzheimer's disease and Parkinson's Disease and Biomarkers for Multiple Sclerosis consortia (evidence level III). Results Our consensus guidelines address contraindications, as well as patient-related and procedure-related risk factors that can influence the development of post-LP complications. Discussion When an LP is performed correctly, the procedure is well tolerated and accepted with a low complication rate.

Original languageEnglish
Pages (from-to)111-126
Number of pages16
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume8
DOIs
Publication statusPublished - 2017

Cite this

Engelborghs, S., Niemantsverdriet, E., Struyfs, H., Blennow, K., Brouns, R., Comabella, M., Dujmovic, I., van der Flier, W., Frölich, L., Galimberti, D., Gnanapavan, S., Hemmer, B., Hoff, E., Hort, J., Iacobaeus, E., Ingelsson, M., Jan de Jong, F., Jonsson, M., Khalil, M., ... Teunissen, C. E. (2017). Consensus guidelines for lumbar puncture in patients with neurological diseases. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, 8, 111-126. https://doi.org/10.1016/j.dadm.2017.04.007