Lumbar Puncture (Spinal Tap) in Children
If your child is sick for a long time now and is not responding well to various medicines, a doctor may recommend ‘lumbar puncture’ for your child. The sheer name of the procedure may scare you, but there is no need to panic. Read this article to know what lumbar puncture is and what are its pros and cons.
What Is Lumbar Puncture?
Lumbar puncture is when a needle is put in the lower back of a child to extract a clear fluid called cerebrospinal fluid. Cerebrospinal fluid is the liquid that surrounds the brain and spinal cord. If there is any infection in these areas, the testing of cerebrospinal fluid helps in diagnosis and treatment. After taking out a small amount of fluid, the needle is then withdrawn. Obviously, as a parent, you will worry because the procedure may sound scary and painful. However, it may cause discomfort to the child more than pain.
Why Is Spinal Tap Performed on Children?
If your child’s doctor suggests a spinal tap, you will obviously think that there is something very wrong. But, you should know the reasons that make the doctor take this decision:
1. To Detect Any Viral or Bacterial Infections
Many times, bacteria or viruses may take refuge in the cerebrospinal fluid by escaping from the nerves or the blood and may cause harm to the nervous system, thereby leading to medical conditions like meningitis or encephalitis.
2. To Detect Neonatal Sepsis
The doctor may suggest a spinal tap to register the presence of any pathogens in the cerebrospinal fluid. This may be done to check whether the cause of sepsis may be some infection of the nervous system.
3. To Detect Nervous System Ailments
Conditions such as Guillain-Barre syndrome and multiple sclerosis are abnormalities or disorders of the nervous system and can only be detected by checking the cerebrospinal fluid.
4. To Check for Subarachnoid Haemorrhage
Subarachnoid haemorrhage may happen when there is any kind of bleeding in the subarachnoid space, and this may occur due to some head trauma or an aneurysm.
5. To Check for Cancer
Certain types of cancers, like lymphoma and leukaemia, can be easily established in kids by checking their spinal fluid.
6. For Special Procedures
Sometimes, for special imaging purposes and a better view of the nervous system or certain treatment options, such as administrating chemo drugs, a lumbar puncture may be recommended.
The Procedure of Lumbar Puncture
The entire procedure of a lumbar puncture roughly takes about half an hour. In this procedure, the doctor carefully inserts a very fine needle just below the spinal cord to extract cerebrospinal fluid.
1. For Babies
Babies and younger children are usually positioned on their side with their knees folded towards their chins.
2. For Kids
Older kids are either made to sit for the procedure with their head leaning forward or by lying on their side.
Once the fluid is collected, the needle is carefully withdrawn, and the doctor will place a small bandage where the needle was inserted.
How to Prepare Your Child for a Lumbar Puncture
Once the doctor explains the detailed procedure, you may be required to sign certain consent forms that may state that you understand the procedure and its associated risks and thus give your consent for the same. Your doctor may like to know about your kid’s medical history and may ask questions regarding any medicinal allergies. He may also suggest that you stop giving any medication that your child might be taking.
Benefits of Lumbar Puncture
Here are some benefits of a spinal tap or lumbar puncture:
- It can save your child from getting exposed to the wrong treatment and medication.
- It helps in establishing some life-threatening conditions or illnesses.
- Meningitis, a severe medical condition, may get diagnosed using this procedure only.
This is an invasive procedure, and thus until it is absolutely necessary, your doctor may not recommend lumbar puncture for your child.
Side effects of Spinal Tap on Kids
If your kid requires this procedure, it is important for you to know its side effects, too. Following are some side effects of lumbar puncture in kids:
- It may cause a headache and may make your kid fussy and cranky.
- It may cause localised swelling at the injection site.
- It may even result in back pain.
What are the Risks Involved
Though there are minimal risks involved with this procedure because it is done by trained professionals only, in some cases following risks may occur:
- Lumbar puncture or spinal tap on a newborn may result in decreased heart rate in sick or premature babies. Such babies may require additional oxygen supply too.
- Improper hygiene may lead to infection at the injection site, which may cause infection in the nervous system.
- The procedure may even lead to rupturing of the blood vessels in the lower back. The leaked blood may reach subarachnoid space and may lead to various neurological disorders.
- If the child moves during the procedure or is not held properly, there is a risk of the blood mixing into the cerebrospinal fluid. This mixed fluid is of no use, and the procedure can only be repeated after a few months.
Care to Be Taken After Lumbar Puncture
It is very important that you take good care of your kid after the procedure is done. Following are some points that you may like to keep in mind:
1. Increase the Fluid Intake
Make sure your kid takes adequate amounts of water to replenish the lost cerebrospinal fluid. Make him sip water, juices, soups and other liquids to pep up his water intake.
2. Ample Rest
Taking rest after the procedure is a must. Make sure that your child gets ample rest after the procedure to help his body heal from the procedure.
3. No Vigorous Physical Activities
Make sure your kid does not move around much and does not indulge in any vigorous physical activity as it may lead to fluid leakage.
4. Maintain Hygiene
Keep the injection site clean and keep changing the bandage as suggested by your doctor. Doing so may reduce the chances of any infection.
When to Consult a Doctor
You must seek immediate medical help under the following cases:
1. Incessant Crying
If your baby keeps crying for no evident reason after the procedure, you should take him to the doctor immediately.
2. Fits or Seizures
If, after the lumbar puncture, your child experiences any kind of fits or seizure, you should seek medical help at the earliest.
Sometimes your baby may vomit during the procedure; however, if your baby keeps vomiting after a few hours or after a few days of the procedure, it may be an indication of some underlying complication.
4. Tired or Drowsy
If you notice that your baby is too drowsy or tired after the procedure or his energy levels are low, you should consult your doctor.
5. Refuses to Eat or Drink
If your baby refuses to eat or drink after the procedure, you need to bring this to your doctor’s notice.
Here are some frequently asked questions about lumbar puncture on newborn babies and kids:
1. How can I keep my child calm during the procedure?
You must stay close to your kid and try to distract him. If he is old enough to understand, then you should prepare him mentally for the same and tell him what he should be expecting from the procedure. Younger babies or children may be given sucrose solution that works like a sedative and keeps them calm during the procedure.
2. How much time will the procedure take?
The procedure of lumbar puncture for a premature baby or for a child of any age takes just a minute or two if he is lying in the correct position and is in a calm state.
This invasive procedure may raise a lot of questions in the minds of the parents, but it is important to understand that sometimes this may be the only option to detect certain life-threatening conditions in children. However, if you have doubts regarding the procedure, you should get in touch with your doctor at the earliest.
Also Read: Encephalitis in Children