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Lumbar Puncture in Patients Who Experienced First Seizure with Fever

Journal of the Korean Pediatric Society 2003;46(10):1008-1012.
Published online October 15, 2003.
Lumbar Puncture in Patients Who Experienced First Seizure with Fever
Jung Kim, Jun Su Lee, Sang Eun Lee, Wan Suk Choi, Sung Ryoung Han, Kyunglae Cho
Department of Pediatrics, College of Medicine, Sungkyunkwan University, Masan Samsung Hospital, Masan, Korea
열이 동반된 첫 경련시의 뇌척수액검사
김정, 이준수, 이상은, 최완석, 한성룡, 조경래
성균관대학교 의과대학 마산삼성병원 소아과
Correspondence: 
Kyunglae Cho, Email: pedikyoung@yahoo.co.kr
Abstract
Purpose
: We aimed to ascertain whether lumbar punctures should be done to prove febrile seizure, and to study what conditions can delay or abolish lumbar puncture.
Methods
: This retrospective study was done for four years, from January, 1996 to December, 1999. The subjects were the patients who visited Masan Samsung Hospital for the first convulsion with fever, and whose age ranged from 1-month to 5-years old. The total number of patients was 197. We investigated the rate of meningitis, which was classified by age, season, convulsion type, associated symptoms, and results of blood test. All data were tested chi-square.
Results
: The diagnosis rate of meningitis among all 197 patients was 7.6%, and of these only one patient was proved to have bacterial meningitis. The rate was high in the young(below 6 month), in males and in summer and autumn. Although the general appearance was good after resolution of the fever, the rate of meningitis was 6.5%. Patients with nausea and vomiting totalled 11%; 9.1% of them were diagnosed with meningitis. The diagnosis rate of meningitis in cases in which additional seizures took place were 33.3%.
Conclusion
: The ultimate goal of lumbar punctures in seizure patients with accompanying fever is to rule out bacterial meningitis, which, has been demonstrated to be rare. So we think that lumbar puncture can be postponed by close observation of pediatrics specialists and skilled nurses.
Key Words: Lumbar puncture, Febrile convulsion, Bacterial meningitis


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