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Dr J Burk
Dr J Burk, Doctor (MD)
Category: Health
Satisfied Customers: 2639
Experience:  MBBS MRCGP
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I have been suffering from post lp syndrome for two months.

Customer Question

I have been suffering from post lp syndrome for two months. After 10 days the doctor performed a blood patch, but it didn't help. I am taking big doses of narcotics for a long time. Any sugesstions that can help me?
Submitted: 4 years ago via Patientsville.
Category: Health
Expert:  Dr J Burk replied 4 years ago.

Hi

 

What symptoms do you have?

 

Dr Jef

Customer: replied 4 years ago.
sever headackes mostly in the temples, eyes and back of the head and nausea.
Expert:  Dr J Burk replied 4 years ago.

Thanks

 

Was this an intentional LP or an accidental dural puncture during an attempted epidural placement?

 

Dr Jef

Customer: replied 4 years ago.
intentional. i had viral menangitis in the summer and it was suspectd i got it again, but this time it was another virus.
Expert:  Dr J Burk replied 4 years ago.

Hi

 

Sorry re delay - I was out of my office.

 

Do your symptoms vary with posture?

 

Dr Jef

Customer: replied 4 years ago.
yes. lying down helps, yet sometimes nothing helps.
Expert:  Dr J Burk replied 4 years ago.

Thanks

 

How soon after the LP did you get the pain ?

 

Dr Jef

Customer: replied 4 years ago.
about 48 hours
Expert:  Dr J Burk replied 4 years ago.

Hi

 

Having had a low pressure headache after a diagnostic LP myself you have my sympathy!

 

The duration of your symptoms is very unusual - the dura should have healed up long before now - also it is most unusual for a blood patch not to work - only if it has been placed at the wrong level would it fail.

 

This leaves only two options.

 

1.repeat the blood patch

 

2.treat conservatively with analgesics/laxatives and expect a spontaneous recovery

 

One study found that 87% of patients had recovered after 6 months.....

 

There are a few other treatments that have been tried such as iv caffeine , desmopressin but none have been validated.

 

Abdominal binders have also been used but are uncomfortable to wear.

 

Patients with long term symptoms are at risk of depression and it is important to be aware of this risk.

 

Dr Jef

 

Please get back to me if you would like to chat some more.

Dr J Burk, Doctor (MD)
Category: Health
Satisfied Customers: 2639
Experience: MBBS MRCGP
Dr J Burk and 2 other Health Specialists are ready to help you
Customer: replied 4 years ago.

Dear Dr Jef,

Thank you for your answer it was very helpful and after you wrote me I spoke to my doctor and he decided to perform another blood patch.

The blood patch was done this morning and I still have a very strong headache, even worse than before. does this meen the procedure did not work, or can it take some time till i feel better?

Thank you,

Rachel Peretz

Expert:  Dr J Burk replied 4 years ago.

Hi

 

Hi, too early to say.

 

Often the patch gives an immediate result - however in a chronic case we need to be more patient for the volume of CSF to increase and for the pressure to return to normal.

 

I'll keep my fingers crossed for you.

 

Dr Jef

Dr J Burk, Doctor (MD)
Category: Health
Satisfied Customers: 2639
Experience: MBBS MRCGP
Dr J Burk and 2 other Health Specialists are ready to help you
Customer: replied 4 years ago.
thank you so much for your answer. I am more optimistic now.
Expert:  Dr J Burk replied 4 years ago.

I am glad.

 

I will keep my fingers crossed for you.

 

Dr Jef

Customer: replied 4 years ago.

Hello Dr Jef,

I am feeling better, of from all narcotics but still feeling a little fuzzy. Do you think I Can say I'm on my way out of this mess?

Customer: replied 4 years ago.
Hello again. I didn't hear from you. It is now 6 days after the blood patch. I am back were I staterd- headakes are back, I am taking narcotics again, and it feels like nothing changed. Do you think it's possible I was missdiagnosed? Do you have any suggestions what I can do to get better?

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