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RESEARCH PRODUCT

The risk of abducens palsy after diagnostic lumbar puncture.

subject

description

Abducens palsy occasionally has been observed after diagnostic lumbar puncture (DLP).1-3 Its risk is not exactly known. We are aware of only one report, which mentions not a single case among 1,341 DLPs when using 22-gauge needles.4 At our clinic, an average of 800 inpatients a year undergo DLP. We usually use 22-gauge needles, and occasionally (in less than 5%), 20-gauge needles. Over a 14.5-year period, we saw two patients with abducens palsy—one unilateral, one bilateral—after DLP. This translates to a risk of less than 1 out of 5,800 DLPs. ### Patient 1. A 61-year-old man with type 2 diabetes noticed progressive weakness of the legs. Neurologic examination revealed proximal paraparesis, loss of deep tendon reflexes of the legs, diminished sensation to touch and pain in a stocking-like pattern, and diminished vibration sense. Nerve conduction studies documented sensorimotor demyelinating neuropathy of the legs and, less pronounced, of the …