Low cerebrospinal fluid protein in African children with febrile convulsions.

Febrile convulsions in childhood constitute one of the commonest medical emergencies in paediatric practice. Although the aetiology, clinical picture, treatment and possible sequelae are described and discussed in the standard paediatric literature, little or no mention is made of the exact cerebrospinal fluid (C.S.F.) composition in this condition (Sheldon, 1951; Grulee and Eley, 1952; Collis, 1952; Moncrieff and Evans, 1953; Nelson, 1954; Livingston, 1954; Chao, Druckman and Kellaway, 1958; D.kaban, 1959; Ford, 1960). Wilcox and Lyttle (1925), Wolman (1957) and Ellis (1960) mention that the total C.S.F. protein concentration in convulsions and meningismus may occasionally be raised. Lennox (1949), Moll (1955) and de Chenar (1959) found no C.S.F. abnormalities; Wilcox and Lyttle (1925) and Levinson (1950) found an occasional increase in sugar. Lennox (1960) quotes Zellweger as having done detailed blood, urine and C.S.F. examinations in patients with febrile convulsions, but does not give the results, and Prichard and McGreal (1958) stated that all 'laboratory tests' were normal in their cases, but did not specifically mention C.S.F. Most authors stress the importance of performing a lumbar puncture on convulsing children to exclude neurological disease, and one is left to conclude that the finding of a normal C.S.F. is to be expected if the convulsions are of the benign febrile type. The range of normality for total C.S.F. protein concentration in children is generally accepted as 15-45 mg./100 ml. (Moncrieff and Evans, 1953; Nelson, 1954; Moll, 1955; Wolman, 1957), with Levinson (1950) and Cumings (1954) giving the lowest levels of normal as 5 mg., and 10 mg./100 ml. respectively, and Wilcox and Lyttle (1925) giving the highest range of 30-80 mg./100 ml. The effect of age on the total C.S.F. protein has been noted by Muller, Jaworski, Silverman and