Clinical and CSF findings in infants with initial episode of febrile convulsion

Background: Although the most common etiologic causes of fever and convulsion are viral infections, sometimes they are caused by a life threatening CNS infection which mandates lumbar puncture for diagnosis. Objective: To evaluate the necessity and importance of lumbar puncture in patients with febrile convulsion. Methods: In a descriptive study, 108 patients under two years of age with febrile convulsion were studied in Shahid Beheshti hospital of Kashan during 1994-96. All cases had undergone lumbar puncture. Clinical signs, physical findings and CSF data were recorded. Statistical analysis was based on information gathering. Findings: CSF findings indicated that 4 patients (3.8%) had meningitis in which the most common clinical manifestation (3 patients) was irritability. Vomiting, drowziness, lethargy and anorexia occurred in 2 patients and only one patient had bulging fontanelle. Meningeal sings were absent in all cases. Conclusion: Lumbar puncture in infants younger than 2 years old with febrile convulsion may be justified in the presence of irritability, drowziness, lethargy and bulging fontanelle.