| Carbaat PA and van Crevel H, 1981, Netherlands | 100 neurological patients undergoing LP all done by same investigator with 18G needle. 50 ambulant, 50-24 hour bed rest. | Controlled trial | Incidence of headache | ambulant- 38% bed rest- 36% (NS) | p not stated small numbers |
| Dieterich M and Brandt T, 1985, Germany | 160 patients undergoing LP for ? MS. 78 with 30 minute prone with head down tilt, 82 immediately ambulant. 20G and 22G needles used | Controlled trial | Incidence of headache | ambulant 41% head down tilt 44% | Statistical significance not assessed. Patients with prior headache excluded. Substudy of needle size may complicate results. Difficult LP excluded. |
| | | Headache described as above | ambulant 18% head down tilt 14% | |
| Vilming ST et al, 1988, Norway | 150 men 150 women for neurological investigation. 75 men and 75 women ambulant. Remainder 3 h prone then 3 h supine. All 22G using needle. | PRCT | Headache | ambulant 35% bed rest 39% (NS) | Significance headache calculated but not stated. Patients with preceding headache excluded. |
| | | Nausea | ambulant 23% bed rest 13% (p<0.05) | |
| Spriggs DA et al, 1992, UK | 110 patients undergoing diagnostic LP. 54 ambulant 56 bed rest for 4 hours | PRCT | Incidence of headache | Ambulant 32% Bed rest 31% (NS) | Statistical significance assessed but not given. Small discrepancies between two groups for needle size and operator experience. Patients with headache excluded. |
| Vimala J et al, 1998, Country not stated but ? India | 204 patients undergoing diagnostic LP. 100 ambulant 104 24 hour bed rest. | PRCT | Incidence of headache | ambulant 15% (95% CI 12 to 22%) bed rest 18% (95% CI 8 to 22%) | Randomisation method unclear but possibly highly flawed. Discrepancies in needle size and operator experience. |
| | | Headache considered severe | Ambulant 57% Bed rest 12% (p=0.02) | |