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[Bilateral hypoxic-ischaemic thalamic lesions in newborns]
M C Banerjea1, J Wirbelauer, A Trusen
1Universitäts-Kinderklinik Würzburg. m_banerjea@hotmail.com
Zeitschrift Fur Geburtshilfe Und Neonatologie
|December 12, 2002
Summary
Bilateral hypoxic-ischaemic thalamic lesions in newborns cause absent suckling and swallowing. Early MRI brain scans are crucial for diagnosis and prognosis, as ultrasound may be normal.
Area of Science:
- Neonatal Neurology
- Neuroscience
- Pediatric Medicine
Background:
- Bilateral hypoxic-ischaemic thalamic lesions are a rare cause of neonatal encephalopathy.
- Clinical features are often misinterpreted, leading to diagnostic challenges.
Observation:
- Two neonates, one preterm and one term, presented with severe intrauterine hypoxia.
- Key symptoms included absent suckling and swallowing, profound hypotonia, weak facial expressions, and feeding difficulties.
- Both infants experienced frequent aspiration pneumonias.
Findings:
- Absent suckling/swallowing with intact cranial nerve function is characteristic of bilateral thalamic hypoxic-ischaemic lesions.
- Lesions may stem from acute, total ischemia, such as cord prolapse or placental abruption.
- Brain MRI is essential, especially when initial ultrasounds are unremarkable.
Implications:
- Bilateral thalamic lesions typically indicate a poor prognosis in affected neonates.
- Prompt diagnosis via MRI can guide management and prognostication.
- Understanding these specific lesions improves the diagnosis of neonatal encephalopathy.