Lumbar puncture in the clinical evaluation of children with seizures associated with fever

Al‐Eissa, Youssef A.

doi:10.1097/00006565-199512000-00004

Cited by 26 publications

(24 citation statements)

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“…Many studies also reported similar results suggesting meningitis is more prevalent in children less than 1 year of age. 2,5,8,10,11 In this study out of 8 children with bacterial meningitis only 1 child had signs of meningeal irritation. Whereas in studies done by Joshi-Batajoo and Laditan AA none of the children with bacterial meningitis had signs of meningeal irritation.…”

Section: Discussionmentioning

confidence: 56%

Predictors of meningitis in children presenting with first episode of febrile seizure

Reddy

Khan

Hegde

2016

Int J Contemp Pediatr

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INTRODUCTIONFebrile seizure is the most common cause of seizures in infants and toddlers presenting in the pediatric emergency department. Two to five percent of children experience at least one or more episodes of febrile seizures. 1Febrile seizures are classified into simple and complex febrile seizures. Simple febrile seizures are defined as generalized seizures occurring only once in a 24-hour period and lasting less than 15 minutes. Whereas, complex/atypical febrile seizures are described as focal seizures, lasting more than 15 minutes and occurring more than one time in 24 hours.2 Simple febrile seizures are benign and self-limiting. They have better prognosis and carry very low risk for further epilepsy. Probability of acute bacterial meningitis presenting as fever with seizures varies from 0.6 % to 6.7 %. 2 ABSTRACTBackground: Febrile seizure is the most common cause of seizures in infants and toddlers presenting to the paediatric emergency department. Two to five percent of children experience at least one or more episodes of febrile seizures. Simple febrile seizures are benign and self-limiting. They have good prognosis and carry very low risk for epilepsy. Probability of acute bacterial meningitis presenting as fever with seizures varies from 0.6% to 6.7%. The American Academy of Paediatrics (AAP) strongly recommends lumbar puncture (for CSF analysis) in the work up of every child under 18 months of age with a first episode of febrile seizure to rule out acute bacterial meningitis. The objective of this study was to determine the occurrence of meningitis in children who presented with first episode of seizure and fever and also the predictors of meningitis among them. Methods: The records of children admitted to Father Muller Medical College and Hospital between 1 st January 2014 to 31 st December 2015 were reviewed. All children between 6 months to 6 years of age having first episode of convulsions, associated with fever were included in the study and subjected to retrospective analysis of data collected from the case sheets. Results: Our study included 105 children with febrile seizures, 49 children had simple febrile seizures (SFS) and 56 children presented as atypical febrile seizures (AFS). Lumbar puncture was performed in 43 children (15 with SFS and 28 with AFS). The CSF analysis was normal in all the children who presented as simple febrile seizures. There was 25.87% prevalence of meningitis in children with atypical febrile seizures who underwent lumbar puncture. The CSF yield suggestive of bacterial meningitis was as high as 50% in children below 1 year in whom lumbar puncture was done. Conclusions: Children presenting with Atypical/Complex febrile seizures who were treated with antibiotics have more likelihood of having meningitis rather than those presenting with simple febrile seizures.

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Section: Discussionmentioning

confidence: 56%

Predictors of meningitis in children presenting with first episode of febrile seizure

Reddy

Khan

Hegde

2016

Int J Contemp Pediatr

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“…In other studies from Asia [26] and the Middle East [27], there were no cases of ABM in children presenting with a feverassociated seizure and no evidence of meningism. In the former [26], there were 5 cases (2%) of ABM among 254 children aged 6 months to 5 years, all with evidence of meningitis.…”

Section: Discussionmentioning

confidence: 78%

“…In the former [26], there were 5 cases (2%) of ABM among 254 children aged 6 months to 5 years, all with evidence of meningitis. In the latter [27], 102 (51%) of 200 children 3 months to 5 years of age with a fever-associated seizure had an LP. Three children had ABM (2%), and all 3 of these children had complex seizure activity among other features of meningitis.…”

Section: Discussionmentioning

confidence: 99%

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Lumbar Puncture in Children from an Area of Malaria Endemicity Who Present with a Febrile Seizure

Laman

Manning

Hwaiwhange³

et al. 2010

CLIN INFECT DIS

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“…[1][2][3][4][5] In 2002, Caroll and Brookfield 6 analyzed 15 retrospective-review studies and found that, of 4102 children with febrile seizures, 33 had bacterial meningitis. Of the 30 children with bacterial meningitis and documented presentations, 4 presented without additional signs of meningitis beyond the febrile seizure.…”

mentioning

confidence: 99%

Pneumococcal Meningitis Presenting With a Simple Febrile Seizure and Negative Blood-Culture Result

Golnik

2007

Pediatrics

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A 12-month-old girl with occult bacterial meningitis presented with a simple febrile seizure. On examination, the patient was alert, interactive, and smiling responsively without meningeal signs, focal neurologic findings, or signs of extreme illness. Her parents were reluctant to allow a lumbar puncture, and the patient was admitted for observation without lumbar puncture. Her fever resolved, and she was playful, had good oral intake, and was discharged 24 hours after admission. Her initial blood-culture result remained negative. Within 24 hours of discharge, the patient had a focal febrile seizure, came back to the hospital, and was found to have meningitis with a penicillin-susceptible, nonvaccine Streptococcus pneumoniae strain 12F.

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Lumbar puncture in the clinical evaluation of children with seizures associated with fever

Cited by 26 publications

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Predictors of meningitis in children presenting with first episode of febrile seizure

Predictors of meningitis in children presenting with first episode of febrile seizure

Lumbar Puncture in Children from an Area of Malaria Endemicity Who Present with a Febrile Seizure

Pneumococcal Meningitis Presenting With a Simple Febrile Seizure and Negative Blood-Culture Result

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