Table 1

Indications for LP in children with suspected CNS infections*

All children with suspected CNS infections#, except those with the following contraindications:-

Shock present (tachycardia and poor peripheral perfusion and/or hypotension)

Reduced level of consciousness (Glasgow Coma Score <13)

Focal neurological signs present:

Unequal, dilated or poorly responsive pupils


Decerebrate or decorticate posturing

Absent doll's eye movements


Hypertension and relative bradycardia

Within 30 minutes of a short convulsive seizure

Following a prolonged convulsive seizure (lasting >30 minutes) or tonic seizure

Local superficial infection

Coagulation disorder

*Modified from references: [1-3,8,12,13] #Including infants < 6 months old, as part of septic screen LP should be reconsidered, following initial treatment in those who have a contraindication at presentation

Kneen et al. BMC Pediatrics 2002 2:8   doi:10.1186/1471-2431-2-8

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