A 2-year-old child presents with a first simple febrile seizure lasting 4 minutes, now fully recovered and alert. Examination is normal. Which statement about lumbar puncture is most accurate?

• A LP is mandatory in all children under 3 years with first febrile seizure
• B LP is not routinely indicated if the child has returned to neurological baseline ✓
• C LP should only be done if CSF PCR is available
• D LP is indicated only if fever exceeds 40°C

Explanation

Lumbar puncture is not routinely indicated for a simple febrile seizure in a well-appearing child who has returned to baseline. It should be considered if there are clinical signs of meningitis, in infants under 12 months (where signs may be subtle), or if the child has not returned to baseline. The decision is based on clinical assessment, not a specific temperature cutoff or age alone.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.