Question of the Day: Imagine that there is a CSF biomarker for disease activity and response to treatment. Imagine that by checking this biomarker (requires spinal tap) once annually, it would markedly improve your long term outcome. WOULD YOU agree to do this? Sound off below, why or why not?

Thanks for this video! My diagnosis was confirmed by a spinal tap which revealed 18 oligoclonal bands after 2 MRIs and the electrical conduction tests. I'd been deteriorating rapidly for a year before finally being diagnosed, but only after I'd experienced all the various symptoms randomly and repeatedly for nearly a decade without anyone figuring out what might have been the cause. It was actually a new psychiatrist who recognized the symptoms on my first visit and he set me up with a neurologist for testing. I got really lucky there.

I just had a lumber puncture today at Torbay hospital as i have possible MS .. this is interesting and well explained .. thank you from the UK

1985. I was falling more than normal and having some tingling in my feet and hands. The doctor thought we needed to check on a few things and one of the tests he took was a lumbar punch. I have nightmares of this. They didn't have me curl up, I was laid flat on a table, strapped feet and handles to hold onto. They numbed things, but I still felt a lot of it. They drew out some fluid, then injected dye, then tilted the table toward the floor to the point I felt my feet would come off, then up where I was standing. They took some either MRI or Cat, I'm not sure which (it's pretty foggy now). But I DO remember the pain, I got the headache that lasted about 12 hours. They kept me in the hospital for a couple days. The doctor said that I had "markers" in my fluid and that he was going to say it was Multiple Sclerosis. I had a bit more trouble over that year, then things settled down. I've had a bit off and on, things like dropping things, my eyes unfocusing, tripping over nothing and falling, and weakness in my legs. I'm having trouble now, but I also have fibromyalgia and Hashimoto's so it's just another autoimmune thing. I do have a wheelchair and when I'm out where I'll have to walk a lot, we use it (electric). The EMT group in our small town knows our address and they have to pick me up off the floor/ground more and more often. I had a chair collapse a couple nights ago and I couldn't stand up on my own. My husband can't lift me, so we had three big firemen over to pull me up and get me seated. So, do I just keep going and weather the storms as they come? I really don't want to be on more medicine, I'm on a lot now.

Just got my CSF lumbar puncture lab results back, and it's positive for the unpaired oligoclonal bands. Dang it. I jumped on the channel here because I was pretty sure you'd have a video about it, and sure enough. Thanks, Dr. B.

Great, informational video, thank you! They think my daughter (32 years old, with 2 kids) may have MS. We are going in today for a spinal tap as they found lesions on the brain (5 of them) - your video made me feel a bit more educated about this subject as we do not have a history of MS in our genetic make up. At least not four generations worth. Thank you for comforting me as we now drive to get the Spinal Tap done.

Brilliant doctor.

I had one LP prior to my MS diagnosis. My journey began with foot drop and now I am completely wheelchair bound. I would certainly have another, but I see that others sadly had bad experiences. Mine was X-ray guided and the only drawback was my fluid moved very slowly. TY Dr Boster for these videos!

All he said was so true I remember imagining huge needles in mind when I heard my first neurologist say to the nurse: no 25 doesn't work... give me a 30 and 22 needle. But everything went fine after all and my Doc was amazing through the process! A nurse helped me feel at ease during the process :D and I'm lucky I'm living through an era where ms research is advancing and something can be done for multiple sclerosis.

This was very informative, all of your MS videos have been very educational and helpful in my journey to learn about MS. Im going through the process of a series of test to determine if I have MS after having Optic Neuritis.

I need to get one soon,. I am way to old for this fear but yet here it is.

Thanks for this Doc! In regard to your question: it depends on how good the Doc doing the tap is! I had a very bad first experience that caused extreme pain. The second attempt went very smooth. If the potential for more frequent LP's will give me a better chance of keeping my mobility, I'll do them every day, if needed.

Thank you so much for this. My neurologist wants to do lumber tap but he didn't explain why. Since my lumbar and back is where most my pain is, naturally, that's scary to consider. Neurologist also wants to do a CS or electro scan test thing (yes I'm drawing a blank), I am not sure why he needs this too. My brain is clear, no signs but I'm positive for impairment both Hoffman's and Babinski, also all the classic signs, optic neuritis etc...list goes on. This was so helpful to understand why he wants these tests and what their designed to help the Dr see.

Learning something all the time from you.🙂

When I was diagnosed, I was diagnosed by CSF. And unbeknownst to me I had so much degenerative disc deterioration. It took multiple attempts, and finally they did it by fluoroscopy.. I had bloody tabs it was just a bad bad ordeal.

Question: What is a Blood Patch and when would it be needed after a LP?

This was a great explanatory video. Especially the NfL stuff. Cheers.

I'm having a lumbar puncture and spinal imaging tomorrow. I'm so anxious, but I know it will hopefully shed some light on my issues. My biggest fear is the spinal headache. 😬

Dr. Boster: I'd like to say that it is great that you put these videos up for everyone to watch. I do not think I'd ever want another LP. I didn't get the headache, but had horrible pain in my back for almost a week. My CSF results showed normal IgG and 2 unpaired oligoclonal bands. Then, in February, I had an EMG/NCV and was told that was normal. Because of the CSF results and the EMG study, I was told to see a counsellor because I was stressed, anxious, or depressed. Anyway, I asked my (general) neurologist about the OCBs being unpaired and why they were there and what could cause them if Lyme, STDs, etc. were ruled out. He just said 4 or more for MS and said I had inflammation in my brain/CNS. My question is, since you are an MS specialist, it normal to have 2 unpaired? If not, what else can cause them? Thanks!

The spinal tap I had was so painful that I never want to do that again. They didn’t do the proper recovery after, and my neuro wasn’t available to do a blood patch. It was a horrible experience all around. But it did establish that I had 13 oligoclonal bands. I had a pretty intense CSF leak during and after an endolymphatic decompression and shunt surgery. That wasn’t pleasant either.

Thank you so much much for making this videos, four months ago I got diagnosed with MS and was a difficult moment for me, but now thanks to your videos I have learned a lot from the disease. Greetings from Guatemala.

Thank you for your videos 😊. I had a LP about 21 years ago...and it was not pleasant. I didn’t feel the entire procedure at all...BUT my insurance dictated that I had to leave the hospital 2 hours after the procedure. I had a SEVERE headache for 4 days. I couldn’t even move my head an each off the pillow. I called neuro doc who did the test and he said if by the next day it doesn’t go away, I have to go back to have a fluid injection back into my spine. I will never do that procedure again.

Hi this is Sue Monroe-McCreery (alias M&M) thank you for explaining the Spial tap. I had one in 2011 and was diagnosed with MS after that and other tests. Nothing was explained to me. Someone from my MS support group told the group about you and I've been listening and learning from you since 2017. I moved from Red Bluff, Ca to Florence, Oregon because of the horrible summer heat in RB. Now I'm within walking distance to my happy place, the beach. I have trouble catching your live sessions so I find whatever you have put out. Thanks for reading my comment and I will keep trying to catch your live sessions. Sue M&M

I also had a severe anaphylactic reaction to the IVIG infusion. The nurse was great and stopped it within 5 minutes. I’ve also tried Betaseron and Copaxone....sever reactions to those meds as well I do not take any ABC medications. I’ve e had two severe Optic Neuritis attacks. My event was during a marriage separation...very stressful.

Thanks. I really appreciate your clear explanations.

Had my lumbar punch this past Thursday 25 April 2024 to check for MS. Its not that bad.

Thank you for a very informative video. I'm glad someone can offer me answers!

Had intradural arachnoid cyst. Had 4lps. Had csf pouring out eye and nose. Recovering from my op. I could hear the csf passing over the ears.

I had such a bad headache even while lying down! I couldn't sleep because it hurt too much -.- it got better drinking water actually, first days I wasn't eating or drinking much from the pain!

I LOVE your videos about MS! Thank you!

Another great video. Keep em coming! The section on the neuro-filament light chains was very interesting. You discussed how these may be able to be used to assess disease activity, my question is, is there any suggestion that these may have a role in the diagnosis also?

You're awesome, Doc!

I continue to find your videos extremely helpful and educational. I'm in the middle of having a diagnosis with the help from doctors at University of Washington.

Fascinating… Very well explained complex process, thank you

Just had my 1st spinal tap. Soooo, I don't think I could agree to 1/year at this point in time.

My LP came back positive for 'Multiple oligoclonal bands'. I have a long history of vertigo, balance and vision issues. Yet my neurologist says that the O-bands aren't relevant!!

Dear Dr. Boster, as ever, this video is so informative and interesting! Sure I would do another spinal tab for checking these biomarkers, if then it would be a better chance to find the "right" DMT for me, cause "my" MS is active and progressive, the disability level is growing higher fast, which makes me very concerned about all this. I guess I am goin to try Lemtrada or Ocrevus. But my liver counts are very bad so my neurologist is very concerned about that! Well, we'll see in two weeks I am having another appointment and a new discussion with her! Wishing you a great weekend, Dr. Boster! All the best from Germany, sincerela Britta

Dr. Boster, How can we use a test that is only 85% accurate? I think the CSF MS test needs to be further proven? Has there been any research toward examining if people with MS have positive oligoclonal banding intermittently? This might explain the unpredictable results that occur. Or maybe we can use other information and different tests. i.e. if a person has a relative with MS.

Super interesting. I have not had to endure a lumbar puncture, as my diagnosis came after 3 MRI scans. My Neurologist says I am super healthy and am not eligible for DMTs. Never had a flare or relapse. I have been super lucky.

Hello, 10 bands and slightly elevated kappa free light chains. Elevated WBC and protein in CFS . No lesions currently. Have had a few in past that goes back around 9 to 10 years ago. Along with walking issues and dizzying that fully recovered. Clear MRI now. So my question is I have been hospitalized with severe nausea and vertigo. Started in Jan 23 it’s now June 23 Not able to walk without a wheelchair on my own. Have had both inpatient and outpatient therapy sessions. Still not improving. Also it’s all on one side including hand tremors . Is there a possibility it’s MS?

Thanks again for this informative video! My first neuro attempted to perform a spinal tap on me in her office, however she was unable to get in after several attempts. Ultimately she stopped because she didn't want to hurt me anymore than what she already had. Since I have had two different bouts of optic neuritis (once in each eye) and many lesions on my brain and spinal, I was good with her decision as well as her prognosis. I've often wondered if a spinal should be attempted again, however I don't guess that's really necessary with my MS.

Thanks for the information. I recently had 4 valves of csf extracted. It was painless at first then the Numbers were off, and even now I still have bits of the pain. Nobody told me how to deal with the after effects

I would have to say if you could do the spinal tap because you have had a lot of experience.

What about using CSF to confirm for any presence of PML when you changing medications ?

I am unsure how I would feel about yearly lumbar punctures. I've had one so far and my biggest concern was the idea of a wound being created in my spinal column. Aren't their concerns of a wound being created that may potentially allow bacteria/viruses access to that spinal column and brain?

Could you explain the JC Virus and MS

My neurologist is not doing anything for my MS. I have secondary progressive. They told me because I am old they won’t treat me. I am having a flair and I don’t know what to do. Should I see my primary care Dr. I feel like I am in limbo.

Thank you 🙏

thank you

Thank you for this informative video. What is the upper range of an igg index where you would consider it elevated?

Thank you! As you know, I have been anxiously awaiting the spinal tap video. In a lot of MS support groups this is a hot topic (whether or not a LP is necessary). I have said it before, and I will say it again, I am glad I had one. When going through the diagnostic process, I too wanted to be absolutely sure this was MS. For me, it just solidified the other findings. I am also extremely claustrophobic, so the LP was WAY easier for me than a brain/spine MrI. As always I have a few questions. I am glad you too agree a higher unpaired O-band count is not predictive or indicative of a worse disease prognosis. Can you explain then why one patient may have a higher count? Is the immune system just running amuck so to speak? Would you expect a higher count during a relapse? Would the numbers fluctuate for a patient depending on their disease activity? I had 16 unpaired O-bands and an elevated IgG index. Questions maybe best addressed in another video, not sure: Why is the thoracic spine not commonly imaged? I read it used to be because the image quality was poor, but now they can obtain decent images. Do you not scan that area regularly either? Is there any reason for a lesion (spinal) to be persistently enhancing over the course of a year (initially centrally enhancing-6 months later peripherally-another 6 months later overall mildly enhancing). As always, thank you! You produce such valuable information to to those of us living with MS, and affected by it.

Hi Dr. Boster. On the topic of diagnostic testing....I’m in the diagnosis phase of my symptoms and have suspected MS as one (of many) possibilities. I received negative ANA test results and was told by two GP’s that this rules out MS, but in my research on MS, I’ve stumbled on many sources suggesting that the ANA test is not a diagnostic tool for MS and that many people with MS have negative ANA test results. Does a negative ANA test result definitely rule out MS?

I’ve heard of oligoclonal bands but I never had a spinal tab done personally. I probably should to get properly diagnosed with MS. I’ve only had unilateral lower limb weakness and vertigo, and an MRI evidence of multiple lesions. Scratching my head.

I have normal CSF report with multiple sclerosis. Can I improve sir.

Hi Dr, I have had 2 brain MRIs for my chronic migraines which indicated T2 hyperintensities. Since then I had some neurological problems, e g visual deterioration, pain nearly constant behind left eye, mild balance and walking problems, vertigo, extreme light and sound sensitivity and mild internal tremor. My biggest problem is extreme fatigue (sleeping 16h/day). My GP is not convinced that I have MS and is reluctant to send me for a Lumbar puncture. Blood tests revealed increased IgG (Kappa freelight chains) and longstanding elevated inflammation. Should I press for referral to a neurologist and or spinal tap?

Good video! Does anyone know what this means? Absent 5 identical gamma restriction bands are observed in CSF and serum. This is indicative of systemic rather than intra- cerebral synthesis of gammaglobulins.

I've been diagnosed with ms for 3-4years now never had a spinal tap never had my vitavitamin d level checked when I had my daughter by c-section my right side collapsed when given the medication to numb me in my back my ms has never been in remission its always active i can barely walk or get help

Hi @AaronBosterMD Thanks for your videos, Dr. Boster! I got diagnosed recently with RRMS. My lumbar puncture results showed 6 oligoclonal bands. What is the prognosis if one has 6 bands? Greetings from Mexico

I was wondering if a high CRP had any significance with a dx of MS?

Is the pressure pressured from a Spinal Tap usually the same as the pressure in the head?

Hi, I’m curious, would spinal fluid still test positive if you changed to an anti-inflammatory diet for a while prior to the LP?

Sharing ❤️

Hi dr Bostor, I have no questions on this video though excellent by the way, but in future could you perhaps do a video on why some people are given a poor prognosis in there disease? I have been given a diagnosis of RES RRMS and poor prognosis, any information would be greatly appreciated

Hello.I want to ask 1. I heard if a person has uric acid he should not has MS.Is it right or wrong? 2 If MRI is normal there is a need to do CSF test?

I just had my lumbar puncture 3 days ago..

No way would I ever have another one! I'm pretty tough but I would choose childbirth again over the LP. From what I hear, some people have better experiences. My doc had the bedside manner of a doorknob,so that didn't help. I had a migraine so bad that a few days after the procedure I ended up in the ER. I couldn't stand or even sit up without being sick. I don't want to scare anyone who may have an upcoming LP scheduled. I'm sure my experience was due to the provider.

Once a person gets to a level of progressive of can they ever become cured? MRI showed bright spots without any contrast?

I have csf is die from it get good doctor that can take good care of it

I was given an MRI & diagnosed with MS (9 lesions on the brain.) Doctors immediately put me on treatments and all sorts of medications. That was 7 years ago. My last 2 or 3 mris came back inconclusive. There’s something there but they can’t say for sure if it’s ms or not. Why wouldn’t they just do a spinal tap? I’m sick of this unknown. These were some top drs in the country so for him to look at me, shrug his shoulders and say we don’t know...was hard. How can I get answers? Can a hospital just do a spinal tap if I told the dr my situation? Any help is greatly appreciated. 🙏🏻🙏🏻

Great video - thank you. So informative. Just curious as to what increased igg synthesis means in csf fluid? I have oligoclonal banding in csf, increased igg index and increased igg synthesis with lesions on MRI - diagnosed with MS in 2014. Is increased igg synthesis the same as increased igg index?

Is it common/ normal to have elevated CSF pressure/ opening pressure- with MS? Or is that an unrelated problem?

Question...I have not been officially diagnosed yet...I have had an MRI of my brain and it did not show any lesions but because of the symptoms I am having they are sending me to a Neurologist anyway cuz the doctor said the scan shows that the myelin ''could have been damaged'' I am showing all signs of PPMS Is it still possible for this to be MS?? PS I dont know why this is coming up under my Husband's name but I am a 51 year old female

I just left a comment on the CIS video but I’ll ask here again. My MRIS are normal but I have optic neuritis and bands noted in my spinal fluid. Is that more CIS or MS?

DO WE NEED A LUMBAR FOR 100% DIAGNOSIS. 2 NEUROLOGIST HAVE SAID YES TO MS FROM MRI. BUT SHOULD I GET A LUMBAR I'M SCARED

Love the informational videos! I was diagnosed 2016 after way too many years of ignoring symptoms and finally an MRI that showed multiple active lesions in brain and spine. I never had a spinal tap performed. Is this something I should be requesting to verify ?

Thank you for these wonderful videos! I was wondering if it’s possible or likely to have these unpaired bands in the CSF and it NOT be related to CIS or MS??

Good ☝️

Hi Dr Aaron . Will a CSF done after 5 doses of methyl prednisone yield correct result to diagnose MS. Also Anti Aquaporin 4 and anti MOG tests are negative. Can I have views please...

Hi Dr B.. One question.. bands that appear negative at the moment of diagnosis can become positive years after? My neuro told me that negative bands indicated good prognosis.. ? Is there any research to support this?

Aaron Boster MD Hi Dr. Boster, Would IVIG or SCIQ of IGG’s for CVID cause positive LP? I have greater than 5 OCB’s in CSF not in serum. I have MRI that is confusing stroke with lesion as it is small and worsening Neurological symptoms. My Infectious disease doctor explained that it would not cause positive OCB’s as it does not cross the blood brain barrier. My Neurologist’s say they are not sure. They do not believe enough evidence exists that it does not contribute to CSF. I am in limbo and debating going off IVIG and re doing my LP, but wanted to know if you had come across this issue.The Common Variable Immunodeficiency is affecting a diagnosis as it is rare. It also affects ability to diagnose another autoimmune via autoantibodies. Thanks for your input & all you do!

My name is fran If my nose i stuffie and runny at the same time off and on for about 2hrs.dose that mean i have csf.

Hi Dr. B how are you? I was diagnosed based on 2 abnormal brain MRI'S,skin anesthesia and multiple other symptoms I'm getting a spinal tap on 12/15/20 If nothing comes up on that, does it mean that the initial diagnosis stands? BTW,you're awesome! I'm learning so much from you : )

Dr.Boster: Could the coexistence of another autoimmune disease impact the accuracy of the LP to diagnose or rule out MS? Does an autoimmune response going on in the blood throw off the index on the IgG? Could OCBs results be impacted by the presence of another autoimmune disease?

I have a few questions regarding my diagnosis of fibromyalgia instead of MS. I have 5 lesions on the left side of my brain, no evidence (supposedly) of spinal lesions and my lumbar puncture had a result of .01, which my neurologist said was "borderline". Because of this, I was referred to an MS specialist, but she told me because I don't have the same symptoms as her sister (who apparently has MS) that I have fibromyalgia. Please explain how they came to this diagnosis. I would be happy to answer any further questions you might have.

I am scheduled to have a spinal tap done because I have had an abnormal MRI showing lesions. But also, I have had reoccurring Bells Palsy - 9x in my life (I am 40 yrs old). I know they are questioning MS, but how will the spinal tap relay information regarding the cause of the Bells Palsy as one of the initial triggers?

Thank you for this video :) I have a question that bothers me since I received the results from the hospital. What if the lumbar puncture results say: negative Lyme IgG + oligoconal bands shows the mirror pattern with the ones in serum? Thank you in advance for your answer

What about a low IgG -1.1 but a high protein, total, csf 47, and high cell count, csf 181?

Hi Doc I love your videos I have a question can nonspecific white matter disease along with ataxia and every other MS symptom be something else I have not had a lumbar puncture yet.

Hi Dr. Boster I have a lumbar puncture in 2017 and ever since then if feels better when I lay down rather than sit up. After having the lumbar puncture I did get a cold and a headache and was and advised to lay flat for a week. Last year I started having headaches and migraines. Could I still have a leak? Is there something else I can do to help with both of theses problems? Thank you:)

They told me I didn't have enough spinal fuild for temporary to tell if I had it, I guess it was a MRI how the dx me with

I had my sample taken, but apperently it's not given the expected results, the MR scan and symptoms says, yes, MS, but the IgG is within normal range. Now waiting for more results of extra testing of blood. I am still wondering if me having a the beginning of a big cold, with serious running nose, and veeery slight fever day before spinal tap, did something to the results.. but will ask my clinic that.

Hi aaron I have been having troubling signs that started in feb 2020 . I suddenly started to have pins and needles in my hands and feet along with tight spasms in my legs and weakness and I can barely walk now. I also am very dizzy, I have bladder problems as well.My symptoms are always here with me each day but there are days that I feel ok. I'm scared to find out that i may have ms and that i will end up in a wheelchair.i have seen my neurologist but my nerve tests and mri are on hold because of covid19. I hope you can get back to me and help me to understand what's happening to me.

Hi Dr. Boater. I’m newly diagnosed and just trying to figure it all out 🤔. I have brain and spine lesions and 11 OCB’s. My pattern is more consistent with RRMS (I had sx they got better, had more sx, then was dx). After watching the video I’m just a little confused. You can have lesions and OCB and have RRMS or PPMS? That distinction is made based on your sx pattern? Thank you for helping all of us!!

I just had neuro consult today, went terrible. ive been having many symptoms for about a year.10 days ago had Mri W/WO contrast of the brain which showed 15 or more non enhanced juxtacortical WM lesions with frontal and parietal lobe predominance. then underwent entire thin slice SPINE MRI W/wo contrast which showed no lesions. Neurologist not satisfied with the mri images or report ??/ wants more repeat MRIs of brain and spine because she feels location of the lesions are not typical location for MS but needs to rule out?? she said they did a terrible job at the hospital's outpatient imaging center? she states if repeat mri does not show lesions where is typical for MS, according to her (periventricular and infratentorial areas) then maybe a spinal tab should be done. I asked why not just do the spinal tap instead of repeat MRIs with more contrast when its only been 10 days since i had both MRIs with contrast. she said no. also said she wants me to go the imaging center next to her office. I would think that If i dont have lesions in those sites then i dont have lesions there! Questions Dr. Boster and I apologize for asking so much but you are the best neurologist/MS guru in the US! 1) does everyone with MS have lesions in the SAME spots! differential diagnosis? GEEz. im wordering if i may have cerebral atherosclerosis/small vessel disease, yes at the age of 33. I have familial hypercholesteromia. In your career have you ever seen FH cause brain lesions ? unfortunately i could not ask neurologist any questions because she didint allow me to. should other things be ruled out in the process. Lyme disease, etc, from my understanding lyme disease can mimic MS symptoms . What if its a parasite or something that i picked up traveling in 3rd world countries? crazy thoughts but it happens 2)should any blood tests be performed as part of MS work up? I would think there should be some type of protocol /work up for patients who present with with MS symptoms and MRI with lesions. 3) Can i come to your clinic, how far out are your appointments? do you do telemedicine? im in idaho i think they are years behind .

Thanks for the video. My eye doctor does an eye scan to look at my optic nerve. I have never had optic neuritis. She calls it a biomarker to look for disease activity and progression. It's quick and easy. No needles :-) I had a lumbar puncture done for my initial MS diagnosis. Honesly, I would not look forward to it yearly. I have no problems with the eye scan. Have you heard of the yearly eye scan as a biomarker and do you feel it is a helpful procedure for detection of disease progression and activity?

I have a question for you, doc. My CSF report doesn’t go into detail about bands or the IgG however, it does say Gram Stain: WBC AB Rare and CSF Modifier: Prot CSF *45.7 (15.0-45.0). Then, it states INDICATION: exacerbation of multiple sclerosis. Are these terms the same as the terms you used or did they not perform the IgG or bands? Additionally, I thought lumbar punctures alone couldn’t diagnose MS. Can you help me understand my results?

I have a LOT of symtoms.... positive oligoclonal bands , but no lesions in the brain! My symtoms is more like lupus.. but the bloodwork is wrong! The doctors are clueless now and I’m soooo tired now..

Hi Dr, what now if your MRI clearly shows lesions in the Corpus Correlium but your spinal fluid is clear. I have also done all the other tests to make sure that it is nothing else.

Does a traumatic tap, resulting in a high reading of rbc's(fresh) alter the test? Should a new tap be considered, or will results from the traumatic tap will be conclusive enough to not warrant another?

48 hrs after Lumbar Puncture and i'm still in misery! Suffering with LP Headache and back pain from laying on my back for 48 hrs straight! Been drinking a 2 liters of caffeinated soda & 64 oz or more of water daily and still no reprieve from this dreaded headache! Bout to lose my mind! How much longer till this headache goes away?!