Febrile Status Epilepticus Does Not Cause CSF Pleocytosis in Children

To investigate if fever-associated status epilepticus (FSE) alone causes cerebrospinal fluid (CSF) pleocytosis, researchers characterized CSF findings in children enrolled in the Febrile Status Epilepticus Study, a prospective, multicenter study of children presenting to one of five emergency departments (EDs) with FSE but no identified central nervous system infection or other pathologic condition. FSE was defined as a single seizure or a series of seizures without interim recovery lasting at least 30 minutes associated with fever >38.4°C.

Of 200 children (age range, 1 month through 5 years; median age, 16 months), 154 (77%) underwent lumbar puncture (LP) at the discretion of the ED attending physician. Children who underwent LP were significantly younger than those who did not (median age, 15 vs. 23 months), less likely to have had prior febrile seizures, and more likely to have longer duration of FSE and presence of focality. Of 136 children with nontraumatic LPs (<1000 CSF red blood cells), 126 (93%) had CSF with ≤3 white blood cells/mm³. Mean CSF protein and glucose levels were within normal limits (22 mg/dL and 90 mg/dL, respectively).