Research Article
Volume 7 Issue 8 - 2018
A Critical Analysis of Lumbar Puncture in the Emergency Management of Febrile Seizures: A Cross-Sectional Study
Eduardo Jorge da Fonseca Lima1,2*, Gabriel Brito de Moura Monteiro2, Alberto de Barros Lima Filho2, Pedro Jorge Serra da Fonseca Lima2 and Lucas Victor Alves1
1Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, Pernambuco, Brazil
2Faculdade Pernambucana de Saúde - FPS, Recife, Pernambuco, Brazil
*Corresponding Author: Eduardo Jorge da Fonseca Lima, Professor, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, Pernambuco, Brazil.
Received: June 21, 2018; Published: July 10, 2018
Citation: Eduardo Jorge da Fonseca Lima., et al. “A Critical Analysis of Lumbar Puncture in the Emergency Management of Febrile Seizures: A Cross-Sectional Study”. EC Paediatrics 7.8 (2018): 737-746.
Abstract
Purpose: Meningitis is the most important differential diagnosis in children with a febrile seizure, and lumbar puncture for cerebrospinal fluid (CSF) collection may be a necessary procedure for establishing a differential diagnosis in cases in which bacterial meningitis is suspected. Nevertheless, since it has been shown that febrile seizure is rarely predictive of meningitis and in even fewer cases is it the only symptom of this pathology, performing CSF collection in pediatric patients presenting with febrile seizures remains a controversial issue. This study evaluated the profile of children with a febrile seizure submitted to CSF collection at a referral hospital for meningitis in northeastern Brazil between January 2013 and May 2014.
Patients and Methods: A cross-sectional, descriptive study in which the records of children of 6 months to 5 years of age presenting with a febrile seizure and submitted to CSF collection were analyzed. Cases with a traumatic lumbar puncture, cases with incomplete data, and patients with a different diagnosis were excluded from the study.
Results: A total of 126 patients were included, 25.40% of 6 - 12 months of age, 34.13% of 1 - 2 years of age and 40.48% of 2 - 5 years of age. Seventy-five (59.52%) were boys and 51 (40.48%) were girls. In 72 children (57.14%), the seizure occurred in the first 24 hours of fever. Associated symptoms were: vomiting (n = 46; 36.51%), altered sensorium (n = 25; 19.84%) and impaired general condition (n = 21; 16.67%); however, in 56 patients (44.44%), there were no other associated signs or symptoms. Signs of meningeal irritation were rare, with neck stiffness being found in 4 patients (3.17%) and headache in 3 (2.38%). CSF findings were normal in 125 children (99.21%) and only one patient presented with viral meningitis.
Conclusion: In children with a febrile seizure, clinical observation could reduce the practice of unnecessary lumbar puncture for CSF collection.
Keywords: Febrile Seizures; Lumbar Puncture; Emergency; Children
Copyright: © 2018 Eduardo Jorge da Fonseca Lima., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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