Utility of Lumbar Puncture in First Simple Febrile Seizure
Thomas F. Heyne
Lauren Allister
Utility of Lumbar Puncture for First Simple Febrile Seizure Among Children 6 to 18 Months of Age
Kimia AA, Capraro AJ, Hummel D, et al. Pediatrics. 2009;123(1):6–12
Background
In 1996, the American Academy of Pediatrics (AAP) issued practice parameters for managing infants with a first simple febrile seizure (FSFS) to assess for bacterial meningitis. These guidelines recommended lumbar puncture (LP) be strongly considered for infants 6 to 12 months of age and considered for children 12 to 18 months of age. As meningitis rates declined following the introduction of highly effective conjugate vaccines (for Haemophilus influenzae b and Streptococcus pneumoniae), this study sought to investigate the incidence of bacterial meningitis in young children with FSFS.
Objectives
To determine bacterial meningitis rates in otherwise healthy infants and young children with FSFS, and assess pediatric emergency department (ED) physician compliance with AAP guidelines for LP.
Methods
Retrospective cohort study in a single US pediatric ED from 1995 to 2006.
Patients
704 children ages 6 to 18 months presenting within 12 hours of FSFS (≤15 minutes duration, no recurrence in 24 hours) who were otherwise well-appearing. Select exclusion criteria: prior seizure, chronic illness, trauma, irritability, lethargy.
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