Need for Lumbar Puncture in Children Younger Than 12 Months Presenting With Simple Febrile Seizure
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Published on: September 20, 2024
Yu Yun Son1, Gun-Ha Kim, Jung Hye Byeon
1From the Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea.
Insights
Routine lumbar puncture is recommended for infants under 12 months with simple febrile seizures. This is due to the potential for bacterial meningitis, even without obvious neurological signs or with up-to-date immunizations.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Conflicting evidence exists on the necessity of lumbar puncture for simple febrile seizures in infants.
- Evaluating the diagnostic yield of lumbar puncture in young children with febrile seizures is crucial.
Purpose of the Study:
- To assess lumbar puncture results in children under 60 months with febrile seizures.
- To re-evaluate the indication for lumbar puncture in infants under 12 months experiencing simple febrile seizures.
Main Methods:
- Retrospective chart review of patients under 60 months with febrile seizures who underwent lumbar puncture.
- Data collected from January 2005 to January 2015.
Main Results:
- Of 816 children with simple febrile seizures, 75 underwent lumbar puncture; 66 were under 12 months.
- Five patients (6.7%) showed cerebrospinal fluid pleocytosis, with 4 under 1 year.
- Three patients (4.0%) were diagnosed with bacterial meningitis (Streptococcus pneumoniae, Klebsiella pneumoniae), aged 4, 8, and 12 months, with no neurological signs.
Conclusions:
- Lumbar puncture should be considered for all infants under 12 months with simple febrile seizures.
- The presence of bacterial meningitis is possible even without neurological signs or with complete immunizations.
Objectives:
Recently, conflicting results have been reported regarding the necessity of routine lumbar puncture in children less than 12 months of age with simple febrile seizure. The aims of this study were to evaluate the results of lumbar puncture in children younger than 60 months of age with febrile seizure and to reassess the need for lumbar puncture in children younger than 12 months with simple febrile seizure.
Methods:
A retrospective chart review was performed in patients younger than 60 months who presented with febrile seizure and underwent lumbar puncture from January 2005 to January 2015.
Results:
A total of 1249 patients presenting with febrile seizure were admitted. Of these, 816 met inclusion criteria for presenting with simple febrile seizure. Lumbar puncture was performed in 75 patients (9.2%; age, mean ± SD, 12.05 ± 9.13 months; male/female, 31/44), who were reviewed. Sixty-six (88.0%) of 75 patients were younger than 12 months. Five patients (6.7%) showed pleocytosis in cerebrospinal fluid, and 4 of them were younger than 1 year of age. Three patients (4.0%) had bacterial meningitis and were 4, 8, and 12 months. Streptococcus pneumoniae (2 patients) and Klebsiella pneumoniae (1 patient) were isolated in cerebrospinal fluid. Nobody had neurologic signs suggesting bacterial meningitis, and all of them completed scheduled immunizations and were up-to-date.
Conclusion:
Lumbar puncture should be considered in every child younger than 12 months of age with a simple febrile seizure owing to lack of abnormal neurologic sign even if immunization is up-to-date.
