题目恕删 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. 以上述说法来看，热痉挛好发的年龄在9个月到五岁之间，腰椎穿刺的适应症是任何怀疑 脑膜炎的可能性以及小於12个月、12-18个月之间的小孩，并没有特别提到大於三岁以上 对腰椎穿刺的适应症。 建议选项(C)(D)均给分 --

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