Most babies with uncomplicated febrile seizures can avoid ...(t highest risk for bacterial meningitis....),Health

Lumbar puncture requires local anesthesia and often sedation. "It is a safe procedure with an extremely low rate of complications," says Kimia. "But it's a needle and it's not fun. We're trying not to do it unless it's absolutely necessary."

Physicians had already started to question its need, as evidenced by declining rates of lumbar puncture over the 11-year study period. One major reason is that rates of bacterial meningitis have greatly declined because of the introduction of vaccines against H. influenzae and pneumococcus, the two major pathogens that cause meningitis, in 1990 and 2000, respectively. "Bacterial meningitis in vaccinated babies is a rare disorder, luckily, in our part of the world," says Kimia.

Simple febrile seizures in babies tend to run in families and are believed to be a reflection of the immaturity of the brain in dealing with rapid changes in temperature. Some researchers believe the speed of the change may be more important that the height of the temperature even a rapid rise from 99 to 101 degrees Fahrenheit can trigger a seizure in susceptible children, Kimia says.

However, the researchers caution that their findings don't necessarily extend to patients with complex febrile seizures, patients with concerning symptoms or signs, or patients who have an underlying illness.

"Lumbar puncture should be considered based on clinical presentation, rather than being done routinely," says Kimia. "If a child appears very ill, is lethargic, fussy, non-responsive, has neurologic symptoms, or has certain clinical signs (such as a certain type of rash or a bulging fontanelle), lumbar puncture should be considered no matter how old the child is."

Kimia hopes the findings will reassure anxious parents. "We have a ha
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