PREVALENCE OF MENINGITIS IN THE FIRST EPISODE OF FEBRILE SEIZURE IN CHILDREN AGED BETWEEN 6 TO 18 MONTHS- TRIPURA MEDICAL COLLEGE & DR BRAM TEACHING HOSPITAL, HAPANIA, AGARTALA, Tripura-799014

Abstract

Background:Febrile seizures (FS) are the most common type of childhood seizures,affecting 2–5% of children older than 1 month and most commonly from 6 months–5 years old. It is a major cause of paediatric admissions worldwide. In India, AAP 2010 guidelines are followed for performing Lumbar Puncture (LP) in first episode of febrile seizure despite India having wide difference in the epidemiology of meningitis and immunisation coverage as compared to USA. This study has been done to find out whether AAP guidelines are applicable in India also or there is a need for our own guidelines. Although FS induce by age related hyper-excitability of the brain to fever,determining the cause of the fever is critical in the evaluation of these children. The relationship between seizure and bacterial meningitis has been identified well in previous studies. Seizures may be the sole presentation of bacterial meningitis in febrile infants. Seizures are the first manifestation of meningitis in 16.7% of children and in onethird of these patients, whereas meningeal signs and symptoms may not be evident. Therefore, it is mandatory to exclude underlying meningitis in children presenting with fever and seizure prior to making the diagnosis of FS. The initial concern in these children is always to make a proper decision regarding to do an LP to exclude meningitis. Awareness of the prevalence of meningitis and its related factors in children presenting with FS to help physicians to make proper decisions in these situations is necessary.There are several clinical studies worldwide reporting the prevalence of meningitis among children with FS. Some of these studies suggest that in the absence of typical meningeal signs, then an LP should be considered in children with complex seizures, prior antibiotic therapy, age less than 12 months, or incomplete vaccination history.The present study determines the prevalence of meningitis and its associated risk factors in children with FS.