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Meningitis is a common cause of convulsive status epilepticus with fever

R F M Chin1, B G R Neville, R C Scott

  • 1Neurosciences Unit, Institute of Child Health, University College London, and Great Ormond Street Hospital for Children NHS Trust, London, UK. r.chin@ich.ucl.ac.uk

Archives of Disease in Childhood
|December 23, 2004
PubMed

Insights

Children with convulsive status epilepticus (CSE) and fever have a high risk of acute bacterial meningitis (ABM). Early antibiotics and lumbar puncture are recommended for suspected ABM in these cases.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases

Background:

  • Convulsive status epilepticus (CSE) in children often presents with fever.
  • Distinguishing CSE with fever from acute bacterial meningitis (ABM) can be challenging due to atypical presentations.

Purpose of the Study:

  • To determine the likelihood of ABM in children with CSE and fever.
  • To assess antibiotic treatment and CSF sampling rates in these patients.
  • To compare ABM risk in CSE with fever versus short seizures with fever.

Main Methods:

  • Prospective, population-based study of childhood CSE.
  • Inclusion of incident CSE cases with fever.
  • Analysis of antibiotic treatment and diagnostic CSF sampling.

Main Results:

  • 17% population risk of ABM in children with CSE and fever.
  • Significantly higher ABM risk compared to short seizures with fever (1.2%).
  • 24 out of 49 CSE cases had fever; 16 received early antibiotics, 9 had CSF sampling, and 4 had confirmed ABM.

Conclusions:

  • A high index of suspicion for ABM is crucial in children with CSE and fever, as classical signs may be absent.
  • Early parenteral antibiotics and lumbar puncture (if no contraindications) are the recommended management strategies.
Abstract

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