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

Alain Joffe, Marie Mccormick, Catherine Deangelis

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)1153-1156
Number of pages4
JournalAmerican Journal of Diseases of Children
Volume137
Issue number12
DOIs
StatePublished - Jan 1 1983

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Febrile Seizures
Spinal Puncture
Decision Support Techniques
Meningitis
Hospital Emergency Service
Seizures
Physical Examination
Neurologic Examination
History
Physicians

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 journalArticle

Joffe, Alain ; Mccormick, Marie ; Deangelis, Catherine. / Which Children With Febrile Seizures Need Lumbar Puncture? A Decision Analysis Approach. In: American Journal of Diseases of Children. 1983 ; Vol. 137, No. 12. pp. 1153-1156.
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