ANALYSIS OF THE RESULTS OF ROUTINE LUMBAR PUNCTURE AFTER A FIRST FEBRILE CONVULSION IN HOFUF, AL-HASSA, SAUDI-ARABIA

Cerebrospinal fluid (CSF) was analysed to determine a lumbar puncture (LP) yield for meningitis in 95 children who presented with their firs t febrile convulsions between July 1993 and June 1994, There were 52 m ales and 43 females aged six months to six years with a mean age of 21 .9 +/- 13.0 months at presentation, 87(91.6%) had simple febrile convu lsions (SFC) while the remaining 8(8.4%) had complex febrile convulsio ns (CFC). The majority of the subjects presented with a sudden onset o f convulsions that were preceded by a day or two history of fever, cor yza, cough and respiratory distress while others had their convulsions preceded by fever and passage of bloody stools, The LP yield for meni ngitis in this series was 63%, The CSF analysis revealed six cases of meningitis comprising an eight month old infant with Haemophilus influ enzae type B (HIB) meningitis, two partially treated pyogenic meningit is and three aseptic meningitis, All of them had presented with febril e convulsions without signs of meningeal irritation, Excluding aseptic meningitis from this series, a 3.1% LP yield for pyogenic meningitis is significant enough to recommend continued performance of LP in chil dren with first febrile convulsions, especially if under the age of ei ghteen months.