Do seizures alter CSF findings in febrile children?

 

LP

Cerebrospinal Fluid Findings in Children with Fever-Associated Status Epilepticus: Results of the Consequences of Prolonged Febrile Seizures (FEBSTAT) tudy

J Pediatr 2012;161:1169-71.

FEBSTAT Study Team

This study of LP results strongly suggests that prolonged seizures (>30 minutes) DO not affect cell counts, glucose levels, or protein levels in the CSF.

CSF abnormalities should not be attributed to seizures and meningitis should be considered.

Mike

ABSTRACT

 

This prospective multicenter study of 200 patients with fever-associated status epilepticus (FSE), of whom 136 underwent a nontraumatic lumbar puncture, confirms that FSE rarely causes cerebrospinal fluid (CSF) pleocytosis.

CSF glucose and protein levels were unremarkable. Temperature, age, seizure focality, and seizure duration did not affect results.

CSF pleocytosis should not be attributed to FSE.

The article is available at: http://www.sciencedirect.com/science/article/pii/S0022347612009250?np=y

Other relevant material

RCH Clinical Practice Guideline on CSF Interpretation

http://www.rch.org.au/clinicalguide/guideline_index/CSF_Interpretation/#seizures

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2 thoughts on “Do seizures alter CSF findings in febrile children?

  1. We reviewed this recently (http://www.ncbi.nlm.nih.gov/pubmed/22241920) and also concluded that CSF pleocytosis in the febrile child should not be attributed to convulsions.

    Our bottom lines were:

    ▶ In the majority of studies, CSF pleocytosis is reported to occur in less than 6% of children with febrile convulsion and is typically mild (generally less than 20×106/l). (Grade B)
    ▶ Some studies suggest an inverse relationship between the interval between convulsion and LP and the likelihood of CSF pleocytosis. (Grade C)
    ▶ There are insufficient data to support the notion that complex and/or prolonged convulsions cause higher rates of CSF pleocytosis than simple febrile convulsions. (Grade D)

    Do febrile convulsions cause CSF pleocytosis?
    Haeusler GM, Tebruegge M, Curtis N.
    Arch Dis Child. 2012 Feb;97(2):172-5. doi: 10.1136/archdischild-2011-301223.

    Nigel Curtis
    Head of Infectious Diseases, RCH
    Professor of Paediatric Infectious Diseases, The University of Melbourne

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