Elevated lumbar puncture opening pressure in aseptic meningitis

Area of Science:

• Neurology
• Infectious Diseases
• Ophthalmology

Background:

• Elevated lumbar puncture opening pressure (ELPOP) is an understudied phenomenon in aseptic meningitis.
• Characterizing ELPOP features is essential for understanding its implications in aseptic meningitis.

Purpose of the Study:

• To investigate the prevalence and clinical features of ELPOP in patients diagnosed with aseptic meningitis.
• To identify potential associations between ELPOP and patient demographics, clinical findings, and cerebrospinal fluid (CSF) parameters.

Main Methods:

• An observational, retrospective, single-center study included 116 adult patients with aseptic meningitis or meningoencephalitis.
• Lumbar puncture opening pressure (LP OP) was measured, with ELPOP defined as >25 cm H2O.
• Demographic data, clinical information, CSF analysis, and optic disc appearance were analyzed.

Main Results:

• 16 patients (14%) presented with ELPOP, averaging 32.4 years old.
• The ELPOP group had a significantly higher Body Mass Index (BMI) (p=0.0081).
• Optic disc swelling was observed in 40% of ELPOP patients versus 3.2% in normal LPOP patients; CSF content showed no significant differences.

Conclusions:

• This study highlights the frequency of ELPOP in aseptic meningitis and its association with increased BMI.
• Measuring LP OP in all aseptic meningitis patients is recommended.
• Further research is needed to establish the threshold for tolerated intracranial pressure (ICP).