Clinical and Imaging Findings of Neonatal Seizures Presenting as Diffuse Cerebral White Matter Abnormality on Diffusion-Weighted Imaging without any Structural or Metabolic Etiology
Maeran Kim,
Jae-Yeon Hwang,
Yeoun Joo Lee,
Yong-Woo Kim,
Shin Yun Byun,
Yun-Jin Lee,
Jeong A Yeom,
Ung Bae Jeon,
Ki Seok Choo,
Kyung Jin Nam,
Storm Nicholas Shaun Reid
Affiliations
Maeran Kim
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
Jae-Yeon Hwang
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
Yeoun Joo Lee
Department of Pediatrics, Pusan National University Children’s Hospital, School of Medicine, Pusan National University, Yangsan, Korea
Yong-Woo Kim
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
Shin Yun Byun
Department of Pediatrics, Pusan National University Children’s Hospital, School of Medicine, Pusan National University, Yangsan, Korea
Yun-Jin Lee
Department of Pediatrics, Pusan National University Children’s Hospital, School of Medicine, Pusan National University, Yangsan, Korea
Jeong A Yeom
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
Ung Bae Jeon
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
Ki Seok Choo
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
Kyung Jin Nam
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
Storm Nicholas Shaun Reid
College of Creative Human Resource, School of Liberal Arts Education, Kyungsung University, Busan, Korea
Purpose Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion- weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retrospectively. Results All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion- restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.
