• Kara B Johnson, Kenneth A Michelson, Todd W Lyons, Lise E Nigrovic, Assaf Landschaft, Tobias Loddenkemper, and Amir A Kimia.
• Boston Children's Hospital Medicine, Division of Emergency Medicine, Boston, MA 02446, United States.
• Seizure. 2014 Aug 1; 23 (7): 573-5.

PurposeTo determine the rate of cerebrospinal fluid (CSF) pleocytosis among children presenting with status epilepticus (SE) without proven central nervous system infection.MethodWe performed a retrospective cross-sectional study of all patients aged one month to 21 years of age who were evaluated in a single pediatric emergency department (ED) for SE between 1995 and 2012. We limited our study to those children who had a CSF culture obtained and excluded those children with proven viral or bacterial infection. We defined SE in a patient who had a single seizure or a cluster of seizures without regaining consciousness which lasted 30 min or longer. We defined CSF pleocytosis as a CSF white blood cells (WBC)>10 cells/mm(3) and a peripheral leukocytosis as WBC ≥ 15,000 cells/mm(3). We compared the rate of CSF pleocytosis between children with and without peripheral leukocytosis using the Fisher's exact test.ResultsWe identified 289 ED visits for SE, of which 178 (62%) met study inclusion criteria. Seven children (4%, 95% confidence interval 1.7-8.2%) had CSF pleocytosis. More children with peripheral leukocytosis had CSF pleocytosis: (8.6% with peripheral leukocytosis vs. 0.9% without leukocytosis, p=0.01).ConclusionCSF pleocytosis is relatively uncommon among children with prolonged seizures, even in the presence of peripheral leukocytosis. Therefore, all children with CSF pleocytosis after status epilepticus need comprehensive evaluation for central nervous system infection.Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

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