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conferenceseries
.com
Volume 6
Journal of Neurological Disorders
ISSN: 2329-6895
CNS 2018
November 12-13, 2018
November 12-13, 2018 | Edinburgh, Scotland
4
th
International Conference on
Central Nervous System Disorders & Therapeutics
Where there is no brain imaging: Safety and diagnostic value of lumbar puncture in patients with
neurological disorders in a rural hospital of Central Africa
Deby Mukendi
University of Kinshasa, Democratic Republic of the Congo
A
nalysis of cerebrospinal fluid (CSF) obtained by lumbar puncture (LP) is an essential step for the diagnostic approach
of neurological disorders in particular neuroinfections. In low-resource settings, it is often the only available diagnostic
method. Despite its key contribution, little is known on the risks and benefits of LP in the large tropical areas where hospital
based neuroimaging is not available. The objectives of this study were to assess the safety and diagnostic yield of LP in a
rural hospital of Central Africa and to identify predictors of CSF pleocytosis (white blood cell count >5/μL) as surrogate
marker of neuro-infections. From 2012 to 2015, 351 patients admitted for neurological disorders in the rural hospital of
Mosango, Kwilu province, Democratic Republic of Congo, were evaluated using a systematic clinical and laboratory workup
and a standard operating procedure for LP. An LP was successfully performed in 307 patients (87.5%). Serious post LP adverse
events (headache, backache or transient confusion) were observed in 23 (7.5%) of them but they were self-limiting and no
death or long-term sequelae were attributable to LP. CSF pleocytosis was present in 54 participants (17.6%), almost always
associated with neuro-infections. Presenting features strongly and independently associated with CSF pleocytosis were fever,
altered consciousness, HIV infection and positive screening serology for human African trypanosomiasis. In conclusion, the
established procedure for LP was safe in this hospital setting with no neuroimaging, and CSF analysis brought a substantial
diagnostic contribution. A set of presenting features may help for accurately selecting the patients for whom LP would be most
beneficial.
debymukendi@gmail.comJ Neurol Disord 2018, Volume 6
DOI: 10.4172/2329-6895-C9-050