My Neuro ordered this as well as Western Blot for tomorrow. Is the Spinal
something used to DX Lyme? Truely not looking forward to it.

LPs are not definitive!!!  Hope it goes well!!
***********************************

The study below suggests a possible reason why Bb may not be detected in spinal
fluid by labs EVEN IF it is present.

--------------------------------------------------------------------------
------
In vitro conversion of Borrelia burgdorferi to cystic forms in spinal fluid,
and transformation to mobile spirochetes by incubation in BSK-H medium.
Brorson O; Brorson S.
Infection, 26(3):144-50. 1998.

Quoting from the abstract:

"B. burgdorferi transformed into cysts (spheroplast L-forms) within 1-24h of
inoculation into spinal fluid. When transferred to a growth medium, the cysts
converted back to normal spirochetes after 9-17 days of incubation. "When
neuroborreliosis is suspected, it is necessary to realize that B. burgdorferi
can be present in a cystic form, and these cysts have to be recognized by
microscopy. This study may also explain why cultivation of spinal fluid often
is negative with respect to B. burgdorferi."

Spinal taps are useful for differential diagnosis of neurological
diseases.  The sensitivity for detecting Lyme is low so a negative
result cannot rule out Lyme infection but a positive for Lyme is highly
signicant indicator of neuroborreliosis.  I was diagnosed by spinal tap
after a year of unexplained neurological problems.  At the time my
Western blot on serum showed some specific bands but did not meet CDC
survailence criteria (which unfortunately have become the de facto
diagnostic criteria used by most docs).  

The procedure is short and involves very little pain other than a
backache for 24-48 hours.  A small fraction of people develop a "spinal
tap headache" which is due to the the puncture in the lumbar sac not
sealing up after the procedure.  If the headache doesn't resolve on its
own in a day or two, they do a procedure where {*filter*} is injected into
the lumbar sac to seal the leak.  I got the headache on one of my five
spinal taps and had to have the {*filter*} patch.  No big deal.

--
to email me use: tuck2 AT home DOT com

That may be true for many people. But to say it involves *very little pain*
only tells what may true for maybe *most or some* of the people--- not all.

For me, it was intense pain -during the procedure, not afterwards. I believe
the doctor was a good one (a friend had same doc same hospital a week
later--- and no problems). I normally have a very high pain tolerance, but
this one made me cry in pain.

Janet in CA

I was told that a spinal was NOT something that NEEDS to be done!  It is an
invasive procedure that very possibly will not tell you or your doc anything
about your LD situation.  However, A SPECT scan can be done which measures the
{*filter*} flow in your brain and can show areas of lack of {*filter*} flow and other
things that can be diagnostic for LD.  I refused to do the spinal that Steere
told me was the only way to detect neurological involvment,(bullshit).  My
husbands Mother died from a spinal after giving birth to his kid sister, so I
refused to put him or myself  thru the stress of the procedure just to satisfy
Steere's record keeping.  I say, go with your gut feeling, and be SURE you can
trust your doc with your life!
Good luck!
LL

Thanks for the response. I was reluctant to have it done but I am being checked
for M.S. as well. I was lucky and it went very well. No headache and not much
discomfort.