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Table 1 Indications for LP in children with suspected CNS infections*

From: The role of lumbar puncture in children with suspected central nervous system infection

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

Hemiparesis/monoparesis

Decerebrate or decorticate posturing

Absent doll's eye movements

Papilloedema

   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

  1. *Modified from references: [13, 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