Role of CSF Analysis for the First Episode of Febrile Seizure among Children between Six Months to Five Years of Age
AbstractIntroduction: A febrile convulsion is defined as a seizure that occurs in association with fever in children
from six months to five years of age, with no evidence of a central nervous system infection or other
identifiable causes of seizure and no history of an afebrile seizure. Simple febrile seizures are brief
(<15 minutes), generalized, and occur in association with fever and only once during a 24-hour period
without postictal pathology. Febrile Seizures have longer duration (>15 min), or have focal features or if
they recur within 24 hours are defined as complex. In May 1996, the American Academy of Paediatrics
(AAP) issued practice parameters regarding the neurodiagnostic evaluation of children with a first simple
febrile seizure, who present within 12 hours after the seizure. It may be due to meningitis. This study
was done to find out role of cerebro spinal fluid (CSF) analysis to rule out the meningitis in different age
group of children presenting with first episode of fever with seizure. Design: A prospective study was
carried out from June 2008 to July 2009 at the Western Regional hospital, Department of Paediatrics,
Pokhara, Nepal. A total of 110 hospitalized children between the age group five months to 5 years were
included in the study. Results: 16 (14.54%) children were diagnosed to have meningitis. In the age
group of 6 – 12 months, 6 (21.4%) had meningitis while in 12-18 months, 6 out of 31 (19.3%) had
meningitis and in more than 18 months age group only 4 out of 51 (7.84%) were detected with meningitis.
Conclusion: In cases of apparent febrile seizure, meningitis should always be considered as a differential
diagnosis. Lumbar puncture is must to rule out meningitis in all children between the ages of six months
to eighteen months presenting with first episode of fever with seizure to rule out meningitis, even in the
absence of meningeal signs.
Key words: Febrile convulsion; CSF; lumber puncture; meningitis
J. Nepal Paediatr. Soc. May-August, 2010 Vol 30(2) 90-93
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