Spectrum of cerebrospinal fluid analysis and nervous system diseases in hospitalised patients: a hospital based prospective study from a hilly state of Himachal Pradesh in North India

Background: The cerebrospinal fluid (CSF) analysis is an invaluable diagnostic aid in various nervous system diseases.  Many times, alterations in normal CSF parameters with variable and overlapping results are challenging in differential diagnosis and treatment of the diseases. The aim of the study is to know the spectrum of CSF analysis and nervous system diseases with different prevalence in our setup. Methods: Total 150 hospitalised patients with various nervous system diseases and indications were subjected to lumbar puncture and the CSF analysis was done, in a period of one year study. Results: A total of 150 patients with mean age of 50.41±19.54 years had male to female ratio of 1.63:1. CSF analysis revealed most of tuberculous meningitis (TBM) in 30(20%) patients with higher adenosine deaminase (ADA) levels of 10.7±20.24 IU/L and lymphocytic leukocytosis (81.93%). Bacterial meningitis in 8(5.3%) patients revealed highest increase in CSF mean protein levels of 349.63±226.39 mg/dL and in mean cell count of 1039.50±930.23 cells/mm 3 . There was significant increase in protein levels and decrease in glucose levels of CSF, both in TBM and bacterial meningitis compared to viral, fungal meningitis and other central nervous system (CNS) diseases(p<0.001). Conclusions: Spectrum of CSF analysis and CNS diseases revealed consistent findings of alteration of normal CSF variables and therefore, was found as an invaluable, rapid and cost-effective differentiating diagnostic tool.