Millichap and Millichap listed criteria for considering a lumbar puncture in a patient with febrile seizures. The authors are from Children's Memorial Hospital and Northwestern University in Chicago.
Patient selection: febrile seizures
Indications for lumbar puncture:
(1) complex febrile seizures
(2) 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.
(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
To read more or access our algorithms and calculators, please log in or register.