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Neonatal seizures accompanied by diffuse cerebral white matter lesions on diffusion-weighted imaging are associated

Kyung Yeon Lee1, Ki Won Oh1, Young Cheol Weon2

  • 1Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|May 13, 2014
PubMed

Insights

Rotavirus infection is linked to seizures and white matter lesions in newborns. Early diagnosis around five days of life is crucial for affected infants.

Area of Science:

  • Neonatal neurology
  • Infectious diseases
  • Neuroimaging

Background:

  • Seizures in full-term neonates can present with white matter lesions on diffusion-weighted imaging (DWI).
  • A subset of these neonates exhibits a high incidence of rotavirus infection.

Purpose of the Study:

  • To investigate the clinical characteristics and diffusion-weighted imaging (DWI) findings in neonates experiencing seizures.
  • To determine the association between white matter lesions on DWI and rotavirus infection in this population.

Main Methods:

  • Retrospective analysis of 30 full-term neonates with seizures admitted between 2008 and 2010.
  • Classification into two groups based on DWI findings: Group A (diffuse symmetric cerebral white matter lesions, no cortical lesions) and Group B (no such DWI findings).
  • Comparison of clinical characteristics, including Apgar scores, age at seizure onset, and rotavirus antigen status, between the two groups.

Main Results:

  • Group A (n=13) showed restricted diffusion in cerebral white matter, including the corpus callosum, with no cortical lesions.
  • Patients in Group A had earlier seizure onset (4.6 days) and a significantly higher rate of positive rotavirus antigen (92.3%) compared to Group B (16.7%).
  • Neurodevelopmental outcomes in Group A included 60% normal and 40% delayed development.

Conclusions:

  • Rotavirus infection should be strongly considered in neonates presenting with seizures and diffuse cerebral white matter lesions on DWI.
  • The findings suggest a specific association between rotavirus infection and white matter injury in neonates, particularly around five days of life.
Abstract

Keywords:
Diffusion magnetic resonance imagingNeonateRotavirusSeizure

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