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Does The Provision Of A Recent Spinal MRI Assist In Guiding The Lumbar Puncture?
Question: Hi,
My wife has been advised that a lumbar puncture may be necessary to best diagnose whether there is a condition.
Is this procedure best down by a neurosurgeon or is a neurologist usually equally qualified to handle the procedure? Are there any benefits to either specialist handling the procedure?
Does the provision of a recent spinal MRI assist in guiding the lumbar puncture or is it of limited to no value in assisting the placement of the needle?
Thank you.
My wife has been advised that a lumbar puncture may be necessary to best diagnose whether there is a condition.
Is this procedure best down by a neurosurgeon or is a neurologist usually equally qualified to handle the procedure? Are there any benefits to either specialist handling the procedure?
Does the provision of a recent spinal MRI assist in guiding the lumbar puncture or is it of limited to no value in assisting the placement of the needle?
Thank you.
Brief Answer:
I would explain as follows.
Detailed Answer:
Hello and thanks for the direct question.
I have read your question regarding the lumbar puncture.
It is a relatively safe and easy to do procedure, in the hands of an experienced specialist whether a Neurologist or a Neurosurgeon.
The main goal is to collect cerebrospinal fluid for lab examination, but pressure, clarity, of the fluid also can be assessed.
An MRI helps in excluding any preexisting conditions around the puncture area ( vascular malformations for example).
I hope this helps.
Feel free to ask if you have further questions.
Take care.
I would explain as follows.
Detailed Answer:
Hello and thanks for the direct question.
I have read your question regarding the lumbar puncture.
It is a relatively safe and easy to do procedure, in the hands of an experienced specialist whether a Neurologist or a Neurosurgeon.
The main goal is to collect cerebrospinal fluid for lab examination, but pressure, clarity, of the fluid also can be assessed.
An MRI helps in excluding any preexisting conditions around the puncture area ( vascular malformations for example).
I hope this helps.
Feel free to ask if you have further questions.
Take care.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr. Spaho,
Thank you for the reply. I note that either a neurologist or neurosurgeon can safely perform the lumbar puncture.
The procedure may be needed as the tests to date don't appear to me to reveal a diagnosis. However, I haven't followed up with a neurologist yet but will so shortly.
I have uploaded the spinal MRI report and blood test results. Would you have any comment on the results to explain what appears to be optic neuritis on the brain MRI?
Thank you.
Thank you for the reply. I note that either a neurologist or neurosurgeon can safely perform the lumbar puncture.
The procedure may be needed as the tests to date don't appear to me to reveal a diagnosis. However, I haven't followed up with a neurologist yet but will so shortly.
I have uploaded the spinal MRI report and blood test results. Would you have any comment on the results to explain what appears to be optic neuritis on the brain MRI?
Thank you.
Brief Answer:
I would explain as follows.
Detailed Answer:
Hello again.
I have gone through MRI and blood tests results that you uploaded.
There are no alterations in the blood tests and no positive antibodies to indicate optic neuritis.
There are no pathological signals of the cervical and thoracic spine to suspect an inflammatory disease.
The suspected diagnosis in this case may have arisen from clinical signs and brain MRI results.
I hope this helps.
Take care.
I would explain as follows.
Detailed Answer:
Hello again.
I have gone through MRI and blood tests results that you uploaded.
There are no alterations in the blood tests and no positive antibodies to indicate optic neuritis.
There are no pathological signals of the cervical and thoracic spine to suspect an inflammatory disease.
The suspected diagnosis in this case may have arisen from clinical signs and brain MRI results.
I hope this helps.
Take care.
Above answer was peer-reviewed by :
Dr. Dr.Raju.A.T
Dear Dr. Spaho,
Thank you for looking through the blood test results and brain and spine MRI reports.
We have further consulted a neurologist who thinks that MS is unlikely to be cause of the optic neuritis. However, he has ordered a few further blood tests, a more focused MRI and a visual evoked potentials test. What type of information could be gathered from a visual evoked potentials test? The clinical neurological exam was normal apart from the vision in the right eye.
In regards to infection, would you agree that a bacterial infection is most unlikely to be a cause but that a viral infection could be present?
Thank you,
Regards.
Thank you for looking through the blood test results and brain and spine MRI reports.
We have further consulted a neurologist who thinks that MS is unlikely to be cause of the optic neuritis. However, he has ordered a few further blood tests, a more focused MRI and a visual evoked potentials test. What type of information could be gathered from a visual evoked potentials test? The clinical neurological exam was normal apart from the vision in the right eye.
In regards to infection, would you agree that a bacterial infection is most unlikely to be a cause but that a viral infection could be present?
Thank you,
Regards.
Brief Answer:
I would explain as follows.
Detailed Answer:
Hello again.
I have read your follow-up question.
Optic nerve disorders cause a reduction in evoked potential amplitudes. They help differentiate between ischemic optic neuropathy, optic neuritis, and compressive optic neuropathy.
In most of the cases of optic neuritis the etiology is more viral than bacterial.
I hope this helps.
Take care.
I would explain as follows.
Detailed Answer:
Hello again.
I have read your follow-up question.
Optic nerve disorders cause a reduction in evoked potential amplitudes. They help differentiate between ischemic optic neuropathy, optic neuritis, and compressive optic neuropathy.
In most of the cases of optic neuritis the etiology is more viral than bacterial.
I hope this helps.
Take care.
Above answer was peer-reviewed by :
Dr. LAKSHMI
Hi, I have provided some attachments. Please review them.
Dear Dr. Spaho,
Thank you for the information and I understand that the vestibular evoked potentials is useful for further differential diagnosis.
Apologies as I tried to upload further scans but there is a limit to the number of attachments I can make. I may ask for the scans to be reviewed in a separate query if ok.
Thank you,
Regards.
Thank you for the information and I understand that the vestibular evoked potentials is useful for further differential diagnosis.
Apologies as I tried to upload further scans but there is a limit to the number of attachments I can make. I may ask for the scans to be reviewed in a separate query if ok.
Thank you,
Regards.
Brief Answer:
I would explain as follows.
Detailed Answer:
Hello again.
You can send me the scans you want me to review, in a separate query.
You can also share them at YYYY@YYYY and address it to my name: Dr Erion Spaho
Waiting.
I would explain as follows.
Detailed Answer:
Hello again.
You can send me the scans you want me to review, in a separate query.
You can also share them at YYYY@YYYY and address it to my name: Dr Erion Spaho
Waiting.
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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