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March 9, 1970

Convulsive Episodes and Lumbar Puncture

Author Affiliations

Syracuse, NY

JAMA. 1970;211(10):1701. doi:10.1001/jama.1970.03170100063023

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To the Editor.—  Samson and his associates are to be congratulated for reminding all physicians that the diagnosis of febrile convulsions is one of exclusion only (210:1918, 1969). There is no excuse for not performing a lumbar puncture on an infant or child who has fever and a seizure, regardless of whether or not there seems to be a cause for the fever.I think the authors are too cautious, however, by limiting their statement to "first major motor seizure." I know of no reason why an infant or child who has true febrile convulsions cannot also have meningitis and have a seizure on that basis. The label of "febrile convulser" should not allow us to rest easy when confronted with a child with fever and convulsions.