로타바이러스 감염과 관련된 신생아 경련과 대뇌백질 손상

로타바이러스 감염과 관련된 신생아 경련과 대뇌백질 손상

Rotavirus-induced seizures in neonates may lead to cerebral white matter injury

(구연):
Release Date : 2017. 10. 27(금)
Saet Byul Kim1, Mi Lim Chung1, Yun Jung Hur1 , Yun-Jung Lim2
Inje University Haeundae Paik Hospital Pediatrics1
Inje University Haeundae Paik Hospital Radiology2
김샛별1, 정미림1, 허윤정1 , 임윤정2
인제대학교 해운대백병원 소아청소년과1
인제대학교 해운대백병원 영상의학과2

Abstract

Objectives: This study aimed to describe the clinical characteristics and distinctive findings of diffusion restriction in cerebral white matter on diffusion-weighted imaging (DWI) in neonates presenting with seizures and to discuss the high incidence of rotavirus infection. Materials & methods: A retrospective review of medical records was performed with neonates admitted to our neonatal intensive care unit owing to seizures, at Haeundae Paik Hospital, between 2012 and 2016. Infants tested positive result for stool rotavirus antigens and diffusion restriction in cerebral white matter were enrolled. Results: Twenty-six full-term neonates were enrolled; their mean birth weight and gestational age were 3,259 ± 527.9 g and 38.6 ± 5 weeks, respectively. They had no history of perinatal asphyxia and were healthy before acute-on-set seizures approximately 4-6 days after birth. Approximately 80% of the infants did not have any signs of infection or gastroenteritis symptoms. DWI revealed distinctive diffusion-restricted lesions in the symmetric cerebral white matter. During follow-up, favorable neurodevelopmental outcomes were observed in 21 (80.8%) infants. Conclusions: Rotavirus infection should be considered in neonates with seizures and clinicians should consider the possibility of white matter injury in these infants. Although it is difficult to draw conclusions about neurodevelopmental outcomes in neonates with white matter injury associated with rotavirus infection, the prognosis is not always benign. Therefore, close attention and follow-up for long-term neurological outcomes is required for these infants.

Keywords: neonatal seizure, rotavirus infection, white matter injury