Frequency of Positive Cerebrospinal Fluid for the 1st Episode of Febrile Seizures in Children 6–24 Months of Age at Hayatabad Medical Complex, Peshawar, Khyber-Pakhtunkhwa.

Abstract

Background: Febrile seizures are one of the most common childhood seizure disorders. While the majority of first simple febrile seizures have a good prognosis, infection of the central nervous system is an important differential, especially in younger children. Examination of the cerebrospinal fluid (CSF) may help in detecting children with findings suggestive of meningitis..

Objective: To determine the frequency of positive cerebrospinal fluid findings among children aged 6–24 months presenting with a first episode of febrile seizure.

Methodology: This was a cross-sectional study which was conducted in Department of Pediatrics, Hayatabad Medical Complex, Peshawar. The total number of children aged 6–24 months who presented within 24 hours of their first febrile seizure were 132 children, collected by non-probability sequential sampling. Clinical characteristics, vaccination status, seizure onset temperature, seizure duration and CSF parameters were noted. Appearance, protein, glucose, and general cellular parameters of CSF were measured. The SPSS version 21.0 software was used for data analysis. The Chi-square test was used to assess the relationship between CSF positivity and demographic and clinical factors and p<0.05 was taken as statistically significant.

Results: The mean age of participants was 14.7 ± 5.4 months, and 76 (57.6%) were male. Positive CSF findings were observed in 43 (32.6%) children, while 89 (67.4%) had negative CSF findings. The mean CSF protein concentration was 44.9 ± 20.1 mg/dL, mean glucose was 55.6 ± 19.0 mg/dL, and mean CSF white blood cell count was 12.4 ± 17.1 cells/µL. Positive CSF findings were significantly associated with younger age (p=0.029), incomplete vaccination status (p=0.028), temperature above 102°F (p=0.001), and longer seizure duration (p=0.021). Gender was not significantly associated with CSF positivity (p=0.513).

Conclusion: Approximately one-third of children aged 6–24 months presenting with their first febrile seizure demonstrated positive CSF findings. Younger age, incomplete vaccination, higher temperature, and longer seizure duration were associated with an increased frequency of CSF positivity. Careful clinical assessment may help identify children in whom CSF examination is particularly important.