Yield of Lumbar Puncture Among Children Who Present With Their First Complex Febrile Seizure

@article{Kimia2010YieldOL,
  title={Yield of Lumbar Puncture Among Children Who Present With Their First Complex Febrile Seizure},
  author={Amir A. Kimia and Elana Pearl Ben-Joseph and Tiffany F Rudloe and Andrew J Capraro and Dean P. Sarco and David Hummel and Patrick R Johnston and Marvin B. Harper},
  journal={Pediatrics},
  year={2010},
  volume={126},
  pages={62 - 69}
}
OBJECTIVE: To assess the rate of acute bacterial meningitis (ABM) among children who present with their first complex febrile seizure (CFS). DESIGN AND METHODS: This study was a retrospective, cohort review of patients aged 6 to 60 months who were evaluated in a pediatric emergency department (ED) between 1995 and 2008 for their first CFS. Cases were identified by using a computerized text search followed by a manual chart review. Exclusion criteria included prior history of nonfebrile seizures… 
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94 Citations
Highly Influential Citations
4
Background Citations
20
Methods Citations
3
Results Citations
4

94 Citations

Citation Type

Citation Type

Necessity of Lumbar Puncture in Patients Presenting with New Onset Complex Febrile Seizures
TLDR
Patients presenting only with 2 short febrile seizures within 24 hours may be less likely to have ABM, and may not require lumbar puncture without other clinical symptoms of neurological disease.
Yield of Lumbar Puncture in Children of Age Six Months to Eighteen Months Who Presented with their first Complex Febrile Seizures
TLDR
In this study 10% of children between 6 months to 18 months of age, who presented with their first CFS; had bacterial meningitis, so the rate of ABM is quite high in the study population.
Do All Children Who Present With a Complex Febrile Seizure Need a Lumbar Puncture?
To Tap or Not: Bacterial Meningitis & Complex Febrile Seizures
TLDR
It is concluded that few patients with CFS have ABM in the absence of other signs or symptoms and note that patients whose only feature of CFS is two brief nonfocal seizures in 24 hours may have a particularly low risk of ABM.
Yield of Diagnostic Studies in Children Presenting With Complex Febrile Seizures
TLDR
Most patients with complex febrile seizures do not require extensive diagnostic workup, and only 1 patient who had a very abnormal presentation in feBrile status epilepticus had positive cerebrospinal fluid culture and abnormal brain computed tomography scan and magnetic resonance imaging.
Utility of Lumbar Puncture in Children Presenting With Status Epilepticus
TLDR
Bacterial meningitis is an uncommon cause of SE and among 126 children with SE who had an LP performed, 8 had CSF pleocytosis, and among these, 5 had received antibiotics before performance of a diagnostic LP.
A Critical Analysis of Lumbar Puncture in the Emergency Management of FebrileSeizures: A Cross-Sectional Study
TLDR
In children with a febrile seizure, clinical observation could reduce the practice of unnecessary lumbar puncture for CSF collection, and only one patient presented with viral meningitis.
Acute meningitis among infants and toddlers with febrile seizures: time for a reappraisal of the value of a lumbar puncture.
TLDR
A retrospective analysis of the number of punctures obtained in febrile seizure patients aged 6-24 months found compliance with the Academy's recommendations was low, as emergency room physicians based their decision whether to obtain a lumbar puncture solely on clinical grounds.
Should patients with complex febrile seizure be admitted for further management?
Simple and complex febrile seizures: is there such a difference? Management and complications in an emergency department
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References

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TLDR
Five history and physical examination items discriminated between children with and without meningitis: a physician visit within 48 hours before the seizure; the occurrence of convulsions on arrival at the emergency room; a focal seizure; suspicious findings on physical and/or neurologic examination; and negative predictive value was 100%.
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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