Open Access, Peer-reviewed
pISSN 2508-4887
eISSN 2508-4895
    Perinatology. 2016 Sep;27(3):168-173. Korean.
    Published online Sep 30, 2016.
    https://doi.org/10.14734/PN.2016.27.3.168
    Copyright © 2016 The Korean Society of Perinatology
    Original Article

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

    Hyun-A Kim, MD, Chae-Ku Jo, MD and Myo-Jing Kim, MD
      • Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea.
    • Correspondence to: Myo-Jing Kim, MD. Department of Pediatrics, Dong-A University College of Medicine, 1,3-ga, Dongdaesin-dong, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2589, Fax: +82-51-242-2765, Email: myojing@dau.ac.kr
    Received July 08, 2016; Revised September 19, 2016; Accepted September 21, 2016.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    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.

    Keywords
    Newborns; Seizures; Rotavirus; Brain magnetic resonance imaging

    Figures

    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).

    Tables

    Table 1
    Comparison of the Clinical Characteristics between Infants with Seizures and without Seizures in Rotavirus Group

    Table 2
    Comparison of the Clinical Characteristics between Infants with Positive Rotavirus and Negative Rotavirus in Seizure Group

    Table 3
    Comparison of the Clinical Characteristics between Infants with Abnormal MRI and Normal MRI in Seizure Group

    Table 4
    Comparison of the Clinical Characteristics between Infants with Positive Rotavirus and Negative Rotavirus in Abnormal MRI Group

    Table 5
    Clinical Characteristics, Seizure Type, MRI and EEG Findings of the Group of Positive Rotavirus and Abnormal MRI

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    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*
    Metrics
    Share
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