Utility of Lumbar Puncture in Children Presenting With Status Epilepticus

Pediatr Emerg Care. 2017 Aug;33(8):544-547. doi: 10.1097/PEC.0000000000001225.


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/mm) 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.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data
  • Encephalitis, Viral / cerebrospinal fluid*
  • Encephalitis, Viral / diagnosis
  • Female
  • Glucose / cerebrospinal fluid
  • Humans
  • Infant
  • Leukocytosis / cerebrospinal fluid
  • Male
  • Meningitis, Bacterial / cerebrospinal fluid*
  • Meningitis, Bacterial / diagnosis
  • Meningitis, Viral / cerebrospinal fluid
  • Meningitis, Viral / diagnosis
  • Polymerase Chain Reaction
  • Retrospective Studies
  • Sensitivity and Specificity
  • Spinal Puncture / methods
  • Spinal Puncture / statistics & numerical data*
  • Status Epilepticus / cerebrospinal fluid
  • Status Epilepticus / etiology*


  • Anti-Bacterial Agents
  • Glucose