FIRST EPISODE OF SEIZURES WITH A FEBRILE ILLNESS IN CHILDREN AGED 6-18 MONTHS- SIGNIFICANCE OF LUMBAR PUNCTURE.

Abstract

Background: Fever with seizures in children may be due to simple febrile seizure, complex febrile seizures or secondary to a neuroinfection. The likelihood of acute bacterial meningitis (ABM) in febrile children with seizures ranges from 0.6% to 6.7%. Objectives: To identify the group of 6-18 month old children with the rst episode of fever with seizure who would benet from cerebrospinal uid (CSF) examination. Method: The study group comprised 6-18 month old children, admitted with a febrile illness and rst episode of convulsion with the admission occurring within 24 hours of the convulsion. Children with previously documented intracranial infection or neurological abnormality were excluded. Results: Of the 29 children included in study, 4 (13.8%) were diagnosed as having ABM. In the 6-12 month age group, 3 (25%) children had ABM compared to one (6 %) in the 12-18 month age group. In the 6-12 month age group 2 of the 3 children with ABM had no meningeal signs and 1 had meningeal signs. In the 12-18 month age group the child with ABM had meningeal signs. Signs of meningeal irritation had high specicity in diagnosing ABM. Conclusions: Lumbar puncture (LP) and CSF examination are important in ruling out ABM, when a child of age 6-18 months presents with rst seizure associated with a febrile illness, particularly so in children aged 6-12 months. Whenever meningeal signs occur in such children, there is a signicant chance of ABM.