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


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

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