Perinatology.  2016 Sep;27(3):168-173. 10.14734/PN.2016.27.3.168.

Neonatal Seizures Accompanied by Cerebral White Matter Injury Associated with Rotavirus Infection

• Kim HA
• Jo CK
• Kim MJ

• KMID: 2355575
• DOI: http://doi.org/10.14734/PN.2016.27.3.168

Abstract

PURPOSE
Few studies have investigated the neurological complications of rotavirus infection in newborns. This study reports on clinical characteristics of newborns with seizures during rotavirus infection period and the neurological complications through case reports of infants who experienced seizures during rotavirus infection and demonstrated deep white matter injury on brain magnetic resonance imaging (MRI).
METHODS
The study retrospectively investigated the medical records of newborn patients with positive rotavirus results who admitted to the neonatal intensive care unit of Dong-a University Hospital between January 2010 and May 2015. We analyzed the clinical characteristics of patients with seizures compared to without seizures among the patients of positive rotavirus results. The clinical characteristics of seizure patients according to the stool rotavirus antigen test results (positive vs. negative) and MRI results (normal vs. abnormal) were compared and analyzed.
RESULTS
Of the 144 infants with positive rotavirus results, 17 infants (11.8%) had the seizures. These 17 patients showed no other symptom except seizures, positive rotavirus results predominantly at 4-6 days after birth, and more abnormal MRI results compared to without seizures. These results investigated in the seizure infants with positive rotavirus and infants of abnormal MRI results with positive rotavirus in same trend. In 15 newborns who showed positive stool test results and abnormal MRI results, seizure symptoms occurred at 4-6 days after birth, mostly following a pattern of clonic seizures. On MRI, all these newborns showed cerebral deep white matter injury in areas including the corpus callosum (CC) and internal capsule. Six out of 15 newborns underwent follow-up MRI scans, and five of them showed porencephalic white matter disease or periventricular leukomalacia.
CONCLUSION
In cases when a newborn shows seizures and cerebral deep white matter injury on diffusion-weighted MRI, rotavirus infection should be strongly suspected, and the patient should be subjected to long-term follow-up for neurological development.

Keyword

Newborns; Seizures; Rotavirus; Brain magnetic resonance imaging

MeSH Terms

Brain
Corpus Callosum
Follow-Up Studies
Humans
Infant
Infant, Newborn
Intensive Care, Neonatal
Internal Capsule
Leukoencephalopathies
Leukomalacia, Periventricular
Magnetic Resonance Imaging
Medical Records
Parturition
Retrospective Studies
Rotavirus Infections*
Rotavirus*
Seizures*
White Matter*

Figure

• 

  Fig. 1 Diffusion-weighted images of the patients. Diffusion-weighted images of the 3 patients (A; patient 8, B; patient 9, C; patient 10) of the group of positive rotavirus and abnormal MRI. Note the high signals on deep white matter, corpus callosum and internal capsule.

• 

  Fig. 2 Follow-up magnetic resonance image (MRI) after 2 weeks from seizure onset of patients A shows porencephaly and cerebromalacia in both frontal and parietal white matter, periventricular leukomalacia around occipital horn (A-1, A-2; patient 8). Likewise, porencephaly in frontal and parietal white matter is demonstrated in follow-up MRI of patient B (B-1, B-2; patient 9).

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