Abstract
Whether all children brought to the emergency room with a first seizure and fever require lumbar puncture (LP) remains controversial. We reviewed the emergency room records of 241 children aged 6 months to 6 years who had this clinical picture. Five history and physical examination items discriminated between children with and without meningitis: a physician visit within 48 hours before the seizure; the occurrence of convulsions on arrival at the emergency room; a focal seizure; suspicious findings on physical and/or neurologic examination. Used in combination, these items (risk factors) identified all children with meningitis but would have spared 62% of children without meningitis the need for LP. In a decision analysis framework, they were as sensitive but more specific than LP in detecting children with meningitis. Most important, their negative predictive value was 100%.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1153-1156 |
| Number of pages | 4 |
| Journal | American Journal of Diseases of Children |
| Volume | 137 |
| Issue number | 12 |
| DOIs | |
| State | Published - Jan 1 1983 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Which Children With Febrile Seizures Need Lumbar Puncture? A Decision Analysis Approach. / Joffe, Alain; Mccormick, Marie; Deangelis, Catherine.
In: American Journal of Diseases of Children, Vol. 137, No. 12, 01.01.1983, p. 1153-1156.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Which Children With Febrile Seizures Need Lumbar Puncture?
T2 - A Decision Analysis Approach
AU - Joffe, Alain
AU - Mccormick, Marie
AU - Deangelis, Catherine
PY - 1983/1/1
Y1 - 1983/1/1
N2 - Whether all children brought to the emergency room with a first seizure and fever require lumbar puncture (LP) remains controversial. We reviewed the emergency room records of 241 children aged 6 months to 6 years who had this clinical picture. Five history and physical examination items discriminated between children with and without meningitis: a physician visit within 48 hours before the seizure; the occurrence of convulsions on arrival at the emergency room; a focal seizure; suspicious findings on physical and/or neurologic examination. Used in combination, these items (risk factors) identified all children with meningitis but would have spared 62% of children without meningitis the need for LP. In a decision analysis framework, they were as sensitive but more specific than LP in detecting children with meningitis. Most important, their negative predictive value was 100%.
AB - Whether all children brought to the emergency room with a first seizure and fever require lumbar puncture (LP) remains controversial. We reviewed the emergency room records of 241 children aged 6 months to 6 years who had this clinical picture. Five history and physical examination items discriminated between children with and without meningitis: a physician visit within 48 hours before the seizure; the occurrence of convulsions on arrival at the emergency room; a focal seizure; suspicious findings on physical and/or neurologic examination. Used in combination, these items (risk factors) identified all children with meningitis but would have spared 62% of children without meningitis the need for LP. In a decision analysis framework, they were as sensitive but more specific than LP in detecting children with meningitis. Most important, their negative predictive value was 100%.
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U2 - 10.1001/archpedi.1983.02140380013005
DO - 10.1001/archpedi.1983.02140380013005
M3 - Article
C2 - 6637930
AN - SCOPUS:0021045631
VL - 137
SP - 1153
EP - 1156
JO - JAMA Pediatrics
JF - JAMA Pediatrics
SN - 2168-6203
IS - 12
ER -