Utility of lumbar puncture for febrile seizures among infants under one year old.

ABSTRACT

Febrile seizure is a frequent cause of hospitalization. Its management remains problematic According to the American Academy of Pediatrics, lumbar puncture, which is not devoid of risk, is strongly recommended in infants under 1 year. 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 puncure should be done in which infant with febrile seizure?" This retrospective study was conducted in the department of pediatrics B in the Children Hospital of Tunis on eight-year period [2000-2008]. In all statistical tests, significance level was set at 0.05. 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 GI 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 5mm [p<0.001], recurrence of seizure in the same day[p=0,006], neurological abnormalities p<0.001], CRP>20 mg/1[p=0.03], hyponatremia 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 infant is older than 7 months, presenting a unique, febrile and short [neurological examination with CRP lumbar puncture should be discussed a case by case but an hospitalization for 24 hours is required for monitoring