Can a lumbar puncture (LP) for the diagnosis of Multiple Sclerosis (MS) cause paranasal sinuses symptoms?

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Last updated: June 7, 2025View editorial policy

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From the Guidelines

No, a lumbar puncture (LP) performed for the diagnosis of Multiple Sclerosis (MS) does not cause paranasal sinus symptoms. Lumbar punctures involve inserting a needle into the lower spine to collect cerebrospinal fluid, which is physically distant from the paranasal sinuses located in the face. The common side effects of an LP include headache, back pain, and rarely infection or bleeding at the puncture site, as reported in a study published in 2022 1. These complications are localized to the lower back or can cause headaches due to changes in cerebrospinal fluid pressure. The paranasal sinuses, which include the maxillary, frontal, ethmoid, and sphenoid sinuses, are not affected by this procedure. If a patient experiences sinus symptoms like facial pain, pressure, congestion, or discharge around the time of an LP, these symptoms are likely coincidental and due to an unrelated condition such as sinusitis, allergies, or an upper respiratory infection, as described in a clinical practice guideline published in 2015 1. Any persistent sinus symptoms should be evaluated separately from the LP procedure. It's worth noting that the use of atraumatic needles and smaller needle diameters can reduce the risk of post-lumbar puncture headache (PLPH), as shown in a study published in 2022 1. However, the relationship between LP and paranasal sinus symptoms is not supported by the evidence, and any such symptoms should be investigated as separate entities. The most recent and highest quality study on the topic, published in 2022 1, does not mention paranasal sinus symptoms as a potential complication of LP, further supporting the conclusion that LP does not cause these symptoms.

From the Research

Lumbar Puncture and Paranasal Sinuses Symptoms

  • There is no direct evidence in the provided studies that links lumbar puncture (LP) for the diagnosis of Multiple Sclerosis (MS) to paranasal sinuses symptoms 2, 3, 4, 5, 6.
  • The studies focus on the diagnosis of MS, the role of LP in diagnosis, and potential complications of LP, but do not mention paranasal sinuses symptoms as a potential complication 2, 3, 4, 5, 6.
  • Complications of LP mentioned in the studies include post-LP headache, back pain, and bleeding risks, particularly in patients taking anticoagulants and antiplatelet agents 3, 5.
  • A case report mentions the development of cerebral venous thrombosis after LP and intravenous high-dose corticosteroids in a child with MS, but does not mention paranasal sinuses symptoms 6.
  • The provided evidence does not support a direct link between LP for MS diagnosis and paranasal sinuses symptoms, suggesting that this potential complication may not be well-represented in the available research 2, 3, 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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