Utility of lumbar puncture for febrile seizure among infant under oine year old.

Abstract

Background:This retrospective study was conducted in the department of pediatrics B in the Children Hospital of Tunis on eightyear period (2000 - 2008). In all statistical tests, significance level was set at 0.05.
Aim: to define the utility of lumbar puncture in the management of febrile seizures in infants under 12 months and to identify risk factors of meningitis and to respond to this question:” lumbar punction should be done in which infant with febrile seizure?”
Methods: This retrospective study was conducted in the department of pediatrics B in the Children Hospital of Tunis on
Results: One hundred and six cases were collected during the period of study. Seizures related to bacterial meningitis were seen in 11 cases (10%). We have separated two groups: G1 infants presented bacterial meningitis, and G2 infants with febrile seizure. The comparison between the two groups G1 and G2 showed the following predictors factors of meningitis: age ²7 months (p=0.035), partial seizure (p=0.028), duration of seizure > 5min (p<0.001), recurrence of seizure in the same day(p=0,006), neurological abnormalities p<0.001), CRP> 20 mg / l(p=0.03), hyponatremia ² 125mmol/l (p=0.01).
The risk of meningitis is very low: 3.1 x 10 -3, if this condition is met: infants older than 7 months, having a unique and short seizure ²5 min, and with a CRP ²
20mg / l.
Conclusion: If the infant is older than 7 months, presenting a unique, febrile and short (² 5min) seizure, having a normal neurological examination with CRP ² 20mg / l, lumbar puncture should be discussed a case by case but an hospitalization for 24 hours is required for monitoring.