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Association of British Neurologists 2018 Meeting Abstracts
Poster session
WED 097 Diagnostic lumbar punctures in IIH: what is the patient experience?
  1. William J Scotton1,2,
  2. Susan Mollan1,3,
  3. Thomas Walters1,
  4. Sandra Doughty4,
  5. Peter Nightingale5,
  6. Hannah Botfield1,2,6,
  7. Keira Markey1,2,6,
  8. Andreas Yiangou1,2,
  9. Shelly Williamson4,
  10. Alexandra Sinclair1,2,6
  1. 1Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
  2. 2Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, B15 2TH, UK
  3. 3Birmingham Neuro-Ophthalmology Unit, Ophthalmology Department, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  4. 4Idiopathic Intracranial Hypertension UK, Registered Charity in England and Wales No. 1143522 and Scotland SC043294
  5. 5Wellcome Trust Clinical Research Facility, University of Birmingham, Birmingham, UK
  6. 6Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, B15 2TH, UK
  7. *share joint senior author, Corresponding Author: Alexandra Sinclair

Abstract

Aims and methods Patients with idiopathic intracranial hypertension (IIH) often report significant morbidity associated with lumbar punctures. We therefore aimed to assess the patient’s experience of diagnostic lumbar puncture (LP) in IIH using an online survey designed in collaboration with IIH: UK (a leading UK charity).

Results 463 patients responded to the survey, and were eligible for analysis, over a 2 month period in 2015. 40% of patients described severe pain during the LP (VRS≥8), and the median pain score during the LP was 7 (VRS, IQR 5–7). The majority of patients felt they received insufficient pain relief (85%). Levels of anxiety about future LP’s were high (median VRS 7, IQR 4–10), with 47% being extremely anxious (VRS≥8). LPs performed as an emergency were associated with significantly greater pain scores compared to elective procedures (median 7, IQR 5–7 vs 6, IQR 4–8, p=0.012). Higher LP pain scores (VRS) were significantly associated with poorly informed patients (Spearman correlation, r=−0.32, p<0.001).

Conclusions This study has shown that a significant number of these patients are experiencing significant morbidity from pain and anxiety. This morbidity is associated with both inadequate pre-procedural information, as well as the setting the LP is performed in.

http://dx.doi.org/10.1136/jnnp-2018-ABN.37

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