POSTLUMBAR PUNCTURE HEADACHE - THE RELATION BETWEEN EXPERIMENTAL SUPRATHRESHOLD PAIN SENSITIVITY AND A QUASI-EXPERIMENTAL CLINICAL PAIN SYNDROME

The between general experimental pain sensitivity and the clinical expression of post-lumbar puncture syndrome (PLPS) was examined in a prospective double-blind study of patients who underwent a lumbar puncture with a 20-gauge spinal needle. In 44 neurology patients randomized pain was induced on the middle phalanges of fingers II-IV of both hands using a tension device on the day before lumbar puncture. Pain intensity was measured using the category sub-dividing procedure. The correspondence between experimental pain stimuli and induced pain intensities could best be described by a logarithmic function. PLPS symptoms were documented in a multi-dimensional quantitative fashion using various scales. Pronounced position-dependent headache occurred in 31% of the patients. There proved to be very significant effects of experimental pain sensitivity on intensity and duration of position-dependent headaches, as well as on vegetative symptoms of PLPS (P ≤ 0.01). The results provide an explanation for the varying interindividual manifestation of PLPS symptoms, in addition to factors already identified such as the size of needle used in individual patients. © 1990.