Logo

Log In Sign Up |  An official publication of: American College of Emergency Physicians
Navigation
  • Home
  • Multimedia
    • Podcasts
    • Videos
  • Clinical
    • Airway Managment
    • Case Reports
    • Critical Care
    • Guidelines
    • Imaging & Ultrasound
    • Pain & Palliative Care
    • Pediatrics
    • Resuscitation
    • Trauma & Injury
  • Resource Centers
    • mTBI Resource Center
  • Career
    • Practice Management
      • Benchmarking
      • Reimbursement & Coding
      • Care Team
      • Legal
      • Operations
      • Quality & Safety
    • Awards
    • Certification
    • Compensation
    • Early Career
    • Education
    • Leadership
    • Profiles
    • Retirement
    • Work-Life Balance
  • Columns
    • ACEP4U
    • Airway
    • Benchmarking
    • Brief19
    • By the Numbers
    • Coding Wizard
    • EM Cases
    • End of the Rainbow
    • Equity Equation
    • FACEPs in the Crowd
    • Forensic Facts
    • From the College
    • Images in EM
    • Kids Korner
    • Medicolegal Mind
    • Opinion
      • Break Room
      • New Spin
      • Pro-Con
    • Pearls From EM Literature
    • Policy Rx
    • Practice Changers
    • Problem Solvers
    • Residency Spotlight
    • Resident Voice
    • Skeptics’ Guide to Emergency Medicine
    • Sound Advice
    • Special OPs
    • Toxicology Q&A
    • WorldTravelERs
  • Resources
    • ACEP.org
    • ACEP Knowledge Quiz
    • Issue Archives
    • CME Now
    • Annual Scientific Assembly
      • ACEP14
      • ACEP15
      • ACEP16
      • ACEP17
      • ACEP18
      • ACEP19
    • Annals of Emergency Medicine
    • JACEP Open
    • Emergency Medicine Foundation
  • About
    • Our Mission
    • Medical Editor in Chief
    • Editorial Advisory Board
    • Awards
    • Authors
    • Article Submission
    • Contact Us
    • Advertise
    • Subscribe
    • Privacy Policy
    • Copyright Information

In Kids with Complex Febrile Seizure, When Can You Forego Lumbar Puncture?

By Landon Jones, MD and Richard M. Cantor, MD, FAAP, FACEP | on September 15, 2021 | 0 Comment
Kids korner
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version
Shutterstock.com

Conclusion

After a complex febrile seizure, well-appearing children who have returned to their baseline and have a normal neurological exam can probably forego the lumbar puncture. Because these studies are retrospective in nature, caution should be employed when exercising this treatment strategy. 

You Might Also Like
  • What Do Studies Say About Antipyretics and Febrile Seizure Recurrence?
  • Prediction Rule Identifies Febrile Infants at Low Risk for Serious Bacterial Infection
  • Will IV Fluids Improve Lumbar Puncture Success?
Explore This Issue
ACEP Now: Vol 40 – No 09 – September 2021

Definition of Complex Febrile Seizures

  • Duration 15 minutes or more
  • Focal neurological signs
  • More than one febrile seizure in 24 hours

Source: Smith DK, Sadler KP, Benedum M. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician. 2019;99(7):445-450.

References

  1. Seltz LB, Cohen E, Weinstein M. Risk of bacterial or herpes simplex virus meningitis/encephalitis in children with complex febrile seizures. Pediatr Emerg Care. 2009;25(8):494-497.
  2. Kimia A, Ben-Joseph EP, Rudloe T, et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics. 2010;126(1):62-69.
  3. Hardasmalani MD, Saber M. Yield of diagnostic studies in children presenting with complex febrile seizures. Pediatr Emerg Care. 2012;28(8):789-791.
  4. Rivas-García A, Ferrero-García-Loygorri C, González-Pinto LC, et al. Simple and complex febrile seizures: is there such a difference? Management and complications in an emergency department. Neurologia (Engl Ed). 2019;S0213-4853(19)30079-9.
  5. Fletcher EM, Sharieff G. Necessity of lumbar puncture in patients presenting with new onset complex febrile seizure. West J Emerg Med. 2013;14(3):206-211.
  6. Guedj R, Chappuy H, Titomanlio L, et al. Do all children who present with a complex febrile seizure need a lumbar puncture? Ann Emerg Med. 2017;70(1):52-62.e6.

Pages: 1 2 | Single Page

Topics: Febrile SeizureLumbar PuncturePediatricsQuality & Safety

Related

  • FACEPs in the Crowd: Dr. John Ludlow

    November 5, 2025 - 0 Comment
  • Nail Bed Injuries: What to Do—or Not to Do

    August 18, 2025 - 0 Comment
  • Differential Diagnosis of an Infant with Easy Bleeding, Bruising

    August 14, 2025 - 0 Comment

Current Issue

ACEP Now: November 2025

Download PDF

Read More

About the Authors

Landon Jones, MD

Dr. Jones is associate professor and pediatric emergency medicine fellowship director at the University of Kentucky Department of Emergency Medicine & Pediatrics in Lexington, Kentucky.

View this author's posts »

Richard M. Cantor, MD, FAAP, FACEP

Dr. Cantor is professor of emergency medicine and pediatrics, director of the pediatric emergency department, and medical director of the Central New York Regional Poison Control Center at Upstate Medical University in Syracuse, New York.

View this author's posts »

No Responses to “In Kids with Complex Febrile Seizure, When Can You Forego Lumbar Puncture?”

Leave a Reply Cancel Reply

Your email address will not be published. Required fields are marked *


*
*


Wiley
  • Home
  • About Us
  • Contact Us
  • Privacy
  • Terms of Use
  • Advertise
  • Cookie Preferences
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 2333-2603