Which Children With Febrile Seizures Need Lumbar Puncture? A Decision Analysis Approach

Alain Joffe, Marie Mccormick, Catherine Deangelis

Research output: Contribution to journalArticlepeer-review


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 languageEnglish (US)
Pages (from-to)1153-1156
Number of pages4
JournalAmerican Journal of Diseases of Children
Issue number12
StatePublished - Dec 1983

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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