Should a lumbar puncture be done for evaluation of her suspected dementia?
Lumbar puncture (LP) is not needed in the evaluation of most patients with dementia. Some indications for LP in patients with dementia are listed below:
- Acute or subacute onset ( less than 8 weeks)
- Evidence of immunosuppression
- Fever or presence of meningeal signs
- Atypical presentation of dementia (e.g., severe headaches, seizures, cranial neuropathies)
- Symptoms of normal-pressure hydrocephalus (NPH)
- Positive serum fluorescent treponemal antibody absorption test
- Abnormalities on CT/MRI brain (e.g., meningeal enhancement)
Initial evaluation of suspected dementia: Asking the right questions. David C. Steffens, MD; Joel C. Morgenlander, MD. Postgrad Med, 1999.
The role of lumbar puncture in the evaluation of dementia: the Durham Veterans Administration/Duke University Study. Becker PM, Feussner JR, Mulrow CD, Williams BC, Vokaty KA. J Am Geriatr Soc. 1985 Jun;33(6):392-6.
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