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

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