9 month old presents s/p simple febrile seizure. Has had nasal congestion. Clinically appears well with no other localizing fever source by history or physical. LP or no LP?

The American Academy of Pediatrics' (AAP) recommends in "Practice Parameter: The Neurodiagnostic Evaluation of the Child With a First Simple Febrile Seizure" published in 1996 that a lumbar puncture be "strongly considered" in infants younger that 12 months with first simple febrile seizure and be "considered" in a child between 12 and 18 months.

A recent study by Amir Kimia et al at Boston Childrens Hospital however finds that the risk of bacterial meningitis presenting as first simple febrile seizure at ages 6 to 18 months is exceedingly low and concludes that these AAP recommendations be reconsidered.

LP or no LP? What is your call?




Source

Kimia, A. et al. "Utility of Lumbar Puncture for First Simple Febrile Seizure Among Children 6 to 18 months of Age" Pediatrics. 2009.

American Academy of Pediatrics. "Practice Parameter: The Neurodiagnostic Evaluation of the Child With a First Simple Febrile Seizure" 1996