Utility of Lumbar Puncture in Children Presenting With Status Epilepticus

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Abstract

Objectives

Because meningitis may trigger seizures, we sought to determine its frequency in children with first-time status epilepticus (SE).

Methods

We performed a retrospective cross-sectional study of children aged 1 month to 21 years who presented to a single pediatric emergency department between 1995 and 2012 with SE and who had a lumbar puncture (LP) performed as part of the diagnostic evaluation. We defined bacterial meningitis as a cerebrospinal fluid (CSF) culture positive for a bacterial pathogen or CSF pleocytosis (CSF white blood cells ≥10 cells/mm3) with a blood culture positive for a bacterial pathogen. We defined viral meningitis or encephalitis using a positive enterovirus or herpes simplex virus polymerase chain reaction test.

Results

Among 126 children with SE who had an LP performed, 8 (6%) had CSF pleocytosis. Of these, 5 had received antibiotics before performance of a diagnostic LP. One child in the cohort was proven to have bacterial meningitis (0.8%; 95% confidence interval [CI], 0%–6%). Two other children had enteroviral meningitis (2/13 tested, 15%; 95% CI, 3%–51%), and 1 had a herpes simplex virus infection (1/47, 2%; 95% CI, 0%–15%).

Conclusions

Bacterial meningitis is an uncommon cause of SE.

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