題目恕刪
Kliegman: Nelson Textbook of Pediatrics, 18th ed.
593.1 Febrile Seizures
Febrile convulsions, the most common seizure disorder during childhood,
generally have an excellent prognosis but may also signify a serious
underlying acute infectious disease such as sepsis or bacterial meningitis.
Therefore, each child with a seizure associated with fever must be carefully
examined and appropriately investigated for the cause of the fever (see
Chapter 175 ), especially when it is the 1st seizure. Febrile seizures are
age dependent and are rare before 9 mo and after 5 yr of age. The peak age of
onset is 14–18 mo of age, and the incidence approaches 3–4% of young children. A
strong family history of febrile convulsions in siblings and parents
suggests a genetic predisposition. Linkage studies in several large families
have mapped the febrile seizure gene to chromosomes 19p and 8q13–21. An
autosomal dominant inheritance pattern is demonstrated in some families.
During the acute evaluation, a physician's most important responsibility is
to determine the cause of the fever and to rule out meningitis or
encephalitis. If any doubt exists about the possibility of meningitis, a
lumbar puncture with examination of the cerebrospinal fluid (CSF) is
indicated. A lumbar puncture should be strongly considered in children <12 mo
of age and considered in those 12–18 mo of age, especially if seizures are
complex or sensorium remains clouded after a short postictal period.
以上述說法來看，熱痙攣好發的年齡在9個月到五歲之間，腰椎穿刺的適應症是任何懷疑
腦膜炎的可能性以及小於12個月、12-18個月之間的小孩，並沒有特別提到大於三歲以上
對腰椎穿刺的適應症。
建議選項(C)(D)均給分
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