Associated Neurologists Letterhead
Associated Neurologists Letterhead
Adult Neurology
Jan Mashman, MD
Martin Kremenitzer, MD
Diane Wirz, MD
John Murphy, MD
Samuel Markind, MD
Neil Culligan, MD
Anna Alshansky, MD
David Thomas Greco, MD
Robert Bonwetsch, MD
Joan Ellen Gereg, APRN, MS
Julie Waight, FNP, APRN
Loralee Richter, MS, PA-C
Melisa Pelikan, RN

Pediatric Neurology
Martin Kremenitzer, MD
Anna Alshansky, MD

Neuropsychology
Stephen Peters, PsyD, ABPN
Michelle Bobulinski, PhD

Clinical Studies
Joan Ellen Gereg, APRN, MS
Margaret Mukwaya, CCRC
Ellen Torabi, LPN, Research Coordinator

Neurophysiology
Paulette Christie, R EEGT

Physical Therapy
Michelle Camarata MHA, Cert. MDT, PT
Cynthia Bahr, PT
Elizabeth Capron, MPT

Administration
Joyce Peters, Director of Business Development & Operations
Wendy White, Office Manager



Information About Lumbar Punctures

The lumbar puncture (LP) is performed by one of our neurologists at Danbury Hospital’s Ambulatory Unit so that the spinal fluid may quickly be transported to the hospital laboratory.

The Procedure

The LP procedure consists of the removal of cerebrospinal fluid from the lower back region. This fluid supplies the nutrients to the brain and spinal cord. The doctor will first numb the lower back region with a local anesthetic and then place a needle through the skin to the sac containing the spinal fluid. A small amount fluid is removed, which your body will replace in about an hour. You may feel a burning sensation while the local anesthetic is given and pressure while the spinal needle is in place. Overall, the LP tends to be much less uncomfortable than most people expect.

The entire LP procedure takes approximately 15-30 minutes, however, you should plan at least 1-2 hours to allow for time to register at the hospital and be placed in a room. After you are registered, a neurologist on hospital duty will be paged to the Ambulatory Unit for the procedure. Although we schedule LPs ahead of time, please be patient if the doctor delayed with a hospital emergency.

Potential Complications

The most common complication from an LP is a headache, called the post-LP headache. This is very distinctive in that it occurs only when you sit or stand. The headache is relieved by lying flat and occurs approximately 20% of the time after an LP. Some suggest that lying flat for 4-5 hours after the LP reduces the chance of a headache. Drinking caffeinated beverages has also been suggested as a preventive measure. You do not need to remain in the hospital for 4 hours, but can lie flat after being driven home. If you develop a post-LP headache, the first measure is to remain in bed and drink plenty of fluids. You can take over-the-counter analgesics such as Tylenol. If these measures are not helping, please call our office for further pain medication. If this medication does not help, there is a simple procedure done by an a nesthesiologist which relieves the headache. This procedure is called a blood patch and consists of placing a small sample of your own blood into the area around the sac containing the spinal fluid, forming a “plug” or “patch.” If you have any further questions, please do not hesitate to ask the doctor at the time of the LP procedure.

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