Clinical Features and Value of Lumbar Puncture for the First Complex Febrile Seizure Patients in a Single Center

Park, Hye Jin; Lee, Kye Hyang

Abstract

PURPOSE
Complex febrile seizures are known for a risk factor for developing later epilepsy and also clinical indication for lumbar puncture to exclude central nervous system (CNS) infections. The purpose of this study is to investigate clinical characteristics of first complex febrile seizures and clinical usefulness of lumbar puncture for these patients to diagnose CNS infections.
METHODS
A retrospective review was performed for patients aged 3 months to 5 years who evaluated for their first complex febrile seizures between September 2006 and June 2011.
RESULTS
121 patients (22.2%) were complex type among 545 cases with febrile seizures. 43 patients (35.5%) had a previous history of simple febrile seizure, 34 cases (28.1%) had a family history. Multiple seizures were the most common subtypes of complex features (74.4%). Lumbar punctures were performed in 42 patients (34.7%). The patient's median CSF(cerebrospinal fluid) white blood cell count was 2.0+/-2.5/microL (range 0-10), and 5 patients(12.5%) had CSF pleocytosis. The causes of fever were as follows: acute pharyngotonsillitis (55.4%), pneumonia (14.9%), exanthem subitum (13.2%), mycoplasma infection (3.3%), influenza (1.7%), urinary tract infection (0.8%), gastroenteritis (0.8%), and unknown (9.9%). There were 3 patients (2.5%) with final diagnosis as encephalopathy, aseptic encephalitis; all of three cases had persistent decreased mentality. During the follow up duration (mean, 31.4+/-14.3 months), one patient(0.8%) developed epilepsy.
CONCLUSION
The presence of abnormal neurologic signs is highly suggestive of underlying CNS pathology in patients with complex febrile seizures, and an important indication for lumbar puncture for these patients.