Patient selection: febrile seizures
Indications for lumbar puncture:
(1) complex febrile seizures
(2) clinical manifestations
Clinical manifestations:
(1) signs of meningitis independent of seizures and fever including meningeal signs
(2) abnormal neurologic exam
Patients who underwent lumbar puncture were more likely to have a head CT scan or EEG performed.
Observations:
(1) age alone was not considered an important criterion
(2) most cases were associated with viral infection. Rapid identification of a viral etiology can reduce lumbar puncture and unnecessary antibiotic therapy.
(3) the risk of bacterial meningitis associated with a first simple febrile seizure is low, especially in a vaccinated child
