LUMBAR PUNCTURE IN THE CLINICAL-EVALUATION OF CHILDREN WITH SEIZURES ASSOCIATED WITH FEVER

This study was prospectively conducted to determine the frequency and yield of lumbar punctures performed in children with fever and seizure s and to identify the criteria that were used by emergency physicians in selecting patients for this diagnostic procedure, During the five-y ear period from 1988 to 1992, 200 previously healthy children aged thr ee months to five years were brought consecutively to the pediatric em ergency department, after their seizure associated with fever. Lumbar puncture was performed in 51% of the cases and resulted in the detecti on of seven (3.5%) cases of meningitis, three (1.5%) of which were bac terial, An age less than 18 months, a febrile illness lasting over 48 hours, suspicious symptoms and signs of meningitis, and complex seizur e features had significant influence on the decision of performing a l umbar puncture. Most children with meningitis had lethargy, irritabili ty, and vomiting, and all had complex seizure features.