UTILITY OF LUMBER PUNCTURE IN FIRST EPISODE OF SIMPLE FEBRILE SEIZURE IN CHILDREN BETWEEN 6 TO 18 MONTHS OF AGE
Abstract
ABSTRACT : introduction : Febrile seizures are the most common seizures occurring in children and are exclusive to childhood[2]. It is most common pediatric emergency and the most common type of seizure every pediatrician is dealing with. It accounts for 2.5% of all seizures in children. Despite progress in understanding of febrile seizure and development of consensus statement about diagnostic evaluation and management there exists diversity of opinion regarding blood investigations, neuro-imaging, Electro Encephalogram (EEG) and need for routine lumber punctures (LP)during a febrile seizure. AIM & OBJECTIVES: To determine utility of lumbar puncture in identifying the group of children aged 6 to18 months having first episode of fever with seizures that would benefit from the procedure. OBSERVATION: Most common cause of fever in febrile seizures was found to be upper respiratory tract infection (38%) children followed by AGE(15%).Family history was present in 12.77% cases of SFS.Most common symptom is cough and cold apart from fever and seizure seen in children .Most common clinical sign was transient lethargy lasting less than <15 minutes seen in 18% cases.In 11.7% cases of SFS a diagnosis of meningitis was made at time of admission. Out of these only 1 case (2.4%) was suggestive of meningitis in the age group of 6 to 12 months. CONCLUSION : Lumbar puncture is necessary to rule out meningitis in all children between the ages of 6 months to 12 months presenting with first episode of fever with seizure to rule out meningitis.
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Aaberg KM, Gunnes N, Bakken IJ, Lund Søraas C, Berntsen A, Magnus P, Lossius MI, Stoltenberg C, Chin R, Surén P. Incidence and Prevalence of Childhood Epilepsy: A Nationwide Cohort Study. Paediatrics. 2017 May;139(5):e20163908. doi: 10.1542/peds.2016-3908. Epub 2017 Apr 5. PMID: 28557750.
Berg, Anne T., and Shlomo Shinnar. "Complex Febrile Seizures." Epilepsia 37.2 (1996).
Knudsen FU ,Paeregaard A ,Anderson R , Anderson J: long term prognosis in febrile convulsions with and without prophylaxis.UQesskr Langer 1997 / 159 (23) :3598-602.
Chang et al :Working memory of school children with history of febrile seizures: A population study .Neurology 2001;57:37.
MillchapJG:Febrile convulsions, Newyork :Macmilan ,1968.
Gerber MA , Berliner BC: The child with a simple febrile seizure . Appropriate diagnostic evaluation. American journal of diseases of children 1981;135(5);431-433.
Nguefack S et al :Clinical ,etiological and therapeutic aspects of febrile convulsions .Arch Pediatr 2010 May;17(5):480-5.
Trainor JL, Hampers LC , Krug SE , Listernick R:Chidren with first time simple febrile seizures are at a low risk of serious bacterial illness. AcadEmerg Med 2001;8:781-7.
WomJ,Medwid K:The low rate of bacterial meningitis in children ,ages 6 to18 months ,with simple febrile seizures .Academic emergency medicine 2011 ;18(11):1114-1120.
Practice parameter : The neurodiagnostic evaluation of the child with a first simple febrile seizure. American Acaademy of Pediatrics.Provisional Committee on quality improvement , subcommittee on Febrile seizures .Pediatrics1996;97:769-72.
Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med. 1976;295(19):1029–1033.
Margaretha L, Masloman N. Correlation between serum zinc level and simple febrile seizure in children. Paediatr Indones 2010; 50: 326-330.
Rosenberg NM, Meert K, Marino D, De Baker K. Seizure sassociated with meningitis. PediatrEmerg Care. 1992;8(2):67–69.
Nozicka C. Lumbar puncture and the first simple febrile seizure.Pediatrics. 1997;99(2):306–307.
Lee JH, Kim JH. Comparison of serum zinc levels measured by inductively coupled plasma mass spectrometry in preschool children with febrile and afebrile seizures. Ann Lab Med. 2012; 32: 19.
Carroll W , Brookfield D .Lumber puncture following febrile convulsion .Arch Dis Child 2002 ;87:238-40.
Peltola H, Salo E, Saxen H. Incidence of Haemophilus influenza etype b meningitis during 18 years of vaccine use: observational study using routine hospital data. BMJ.2005;330(7481):18–19.
Green SM, Rothrock SG, Clem KJ, Zurcher RF, Mellick L. Can seizures be the sole manifestation of meningitis in febrile children? Pediatrics. 1993;92(4):527–534.
Whitney CG, Farley MM, Hadler J, et al. Decline in invasive pneumococcal disease after the introduction of protein –polysaccharide conjugate vaccine. N Engl JMed.2003;348(18):1737–1746.
Kaplan SL, Mason EO Jr, Wald ER, et al. Decrease of invasive pneumococcal infections in children among 8 children’s hospitals in the United States after the introduction of the 7-valentpneumococcal conjugate vaccine. Pediatrics. 2004;113(3):443–449.
Kyaw MH, Lynfield R, Schaffner W, et al. Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. N Engl J Med. 2006;354(14):1455–1463.
Teach SJ GeilPA:Incidence of bactermia ,urinary tract infections, and unsuspected bacterial meningitis in children with febrile seizures.PediatrEmerg Care 1999 Feb ;15(1) :9-12.
Hampers LC, Thompson DA, Bajaj L, Tseng BS, Rudolph JR. Febrile seizure: measuring adherence to AAP guidelines among community ED physicians. PediatrEmerg Care. 2006;22(7):465–469.
Forsgren L, Sidenvall R, Blomquist HK, HeijbelJ:A prospective incidence study of febrile convulsions.Acta pediatric Scandinavia 1990;79(5):550-7.
Martin Offringa,Alice A JM et al:Prevalence of febrile seizures in Ducth schoolchildren paediatric and perinatal Epidemiology1991;5:181-188.
Nelson et al:Prognosis of children in febrile seizures. Pediatrics 1978;61:720.
Miller et al: A containing study of health and illness in young children within their families .Oxford 1960; p164-173.
BRharucha B et al : Epidemiological study of febrile seizures with family history and HLA .Indian pediatrics 1992 ;vol29:1479-1485.
Lee JH, Kim JH. Comparison of serum zinc levels measured by inductively coupled plasma mass spectrometry in preschool children with febrile and afebrile seizures. Ann Lab Med. 2012; 32: 19.
Margaretha L, Masloman N. Correlation between serum zinc level and simple febrile seizure in children. Paediatr Indones 2010; 50: 326-330.
Gunduz Z, Yavuz I, Koparal M, Kumandas S, Saraymen R. Serum and cerebrospinal fluid zinc levels in children with febrile convulsions. Acta Paediatr. Jpn. 1996; 38: 237-241.
Lewis MH, Parry JV, Parry RP. Role of viruses in febrile convulsion. Arch Dis Child 1979; 54: 869-876.
Saleh F. Al-Ajlouni, Imad H. Kodah. Neurosciences 2000; 5: 151-215.
Lober J ,Sunderland R : Lumber puncture in children with convulsions associated with fever . Lancet 1980;1(8172):785-786.
Maytal J et al :The value of early postictal EEG in children with FS .Epilepsia 2000 Feb ;41(2):219-21.
Batra P,Gupta S, Gomber S ,SahaA.Predictors of meningitis in children presenting with first febrile seizures.Pediatr Neurol.2011Jan ;44(1):35-9.
W Shrestha SK:role of CSF analysis for the first episode of febrile seizures among children 6 months to5 years of age J.NepalPediatr society 2010;30(2):90-93.
Amir A,Kimia,AndrewJ,Capraro,DavidHummelet et al: Utility of Lumber Puncture for First simple febrile seizure among Children 6 to 18 months of age. Pediatrics 2009;123;6
Chungnath M , Shorvon S: The mortality and morbidity of febrile seizures .Nat Clin Pract Neurol.2008 Nov ;4 (11);610-2.
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