CONTROVERSY

Diagnosis

Lumbar puncture following febrile convulsion

W Carroll, D Brookfield

The Neonatal Unit, City General Hospital, Stoke on Trent, UK

Correspondence to:
Correspondence to:
Dr D Brookfield, The Neonatal Unit, City General Hospital, Stoke on Trent ST4 6QG, UK;
brookfielddavid@hotmail.co.uk

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A painful pointless procedure?

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Keywords: lumbar puncture; febrile convulsion; meningitis

The first 150 words of the full text of this article appear below.

Much of the medicine we practice is enshrined in dogma. The management of children following febrile seizures is no exception. Every 5–10 years, the value and need for various investigations or treatment has been revisited in the medical press. However, despite the commonness of this clinical problem, consensus over management remains elusive. In particular, the need for lumbar puncture following a febrile seizure in infancy continues to be debated despite many attempts to assess its value. This article examines current guidelines, practice, and the available evidence of the value (and potential risks) of lumbar puncture following a febrile convulsion.

The most recently available national guidelines for the management of convulsions with fever in the United Kingdom were issued in 1991.¹ These were published in the British Medical Journal under the heading "For debate" and were agreed by a panel of 21 invited participants. This paper began by defining febrile . . . [Full text of this article]

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Relevant Article

Atoms

Harvey Marcovitch
Arch. Dis. Child. 2002 87: 173. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Kimia, A. A., Capraro, A. J., Hummel, D., Johnston, P., Harper, M. B. (2009). Utility of Lumbar Puncture for First Simple Febrile Seizure Among Children 6 to 18 Months of Age. Pediatrics 123: 6-12 [Abstract] [Full Text]  
• Golnik, A. (2007). Parental Attitude to Lumbar Puncture for Children With Fever and Seizure: In Reply. Pediatrics 120: 1221-1221 [Full Text]  
• Golnik, A. (2007). Pneumococcal Meningitis Presenting With a Simple Febrile Seizure and Negative Blood-Culture Result. Pediatrics 120: e428-e431 [Abstract] [Full Text]  
• Kneen, R, Appleton, R (2005). Status epilepticus with fever: how common is meningitis?. Arch. Dis. Child. 90: 3-4 [Full Text]  
• Chin, R F M, Neville, B G R, Scott, R C (2005). Meningitis is a common cause of convulsive status epilepticus with fever. Arch. Dis. Child. 90: 66-69 [Abstract] [Full Text]  
• Berkley, J. A., Versteeg, A. C., Mwangi, I., Lowe, B. S., Newton, C. R. J. C. (2004). Indicators of Acute Bacterial Meningitis in Children at a Rural Kenyan District Hospital. Pediatrics 114: e713-e719 [Abstract] [Full Text]  
• Waruiru, C, Appleton, R (2004). Febrile seizures: an update. Arch. Dis. Child. 89: 751-756 [Abstract] [Full Text]  
• (2003). Community child health and accident & emergency. Arch. Dis. Child. 88: A24-27 [Full Text]  
• Fenton, T H (2003). A self-fulfilling prophesy?. Arch. Dis. Child. 88: 178-178 [Full Text]  
• Riordan, F A I, Cant, A J (2002). When to do a lumbar puncture. Arch. Dis. Child. 87: 235-237 [Full Text]  

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A self-fulfilling prophesy?

Theo H Fenton

ADC Online, 20 Sep 2002 [Full text]