Distinctive pattern of white matter injury in neonates with rotavirus infection

Yeom, Jung Sook; Kim, Youngsoo; Seo, Ji‐Hyun; Park, Ji Sook; Park, Eun Sil; Lim, Jae‐Young; Woo, Hyang‐Ok; Youn, Hee‐Shang; Choi, Dae Seob; Chung, Joonho; Han, Tae-Hee; Park, Chan-Hoo

doi:10.1212/wnl.0000000000001107

Cited by 34 publications

(83 citation statements)

References 26 publications

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“…In the following decade, rotavirus was ignored as a cause of neonatal seizures. However, recent studies11121318) that included neuroimaging again suggested rotavirus as a cause of neonatal seizures or WMI.…”

Section: History Of Rotavirus As a Cause Of Neonatal Seizuresmentioning

confidence: 99%

“…Third, the developing brain can be damaged by afebrile infections outside the central nervous system (CNS). Although further studies are needed to establish the relationship between rotavirus infection and WMI in term neonates, these recent reports111213) underscore the need for a paradigm shift recognizing the following: (1) that common viral infections can induce WMI in term neonates without direct viral invasion, and (2) that rotavirus is a common cause of neonatal seizures in term neonates.…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, recent reports of neonatal seizures associated with rotavirus infection in term neonates suggest several new and surprising perspectives111213). First, infection/inflammation might induce WMI in term-neonates as well as preterm neonates.…”

Section: Introductionmentioning

confidence: 99%

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White matter injury following rotavirus infection in neonates: new aspects to a forgotten entity, 'fifth day fits'?

Yeom

Park

2016

Korean J Pediatr

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That rotavirus infection can cause neurological symptoms in young children has been well established. However, it is surprising why rotavirus infection has been overlooked as a cause of neonatal seizures for many years, despite significant research interest in neonatal rotavirus infection. Neonates are the age group most vulnerable to seizures, which are typically attributed to a wide range of causes. By contrast, because rotavirus infection is usually asymptomatic, it has been difficult to identify an association between this virus and neonatal seizures. The conventional wisdom has been that, although neonates are commonly infected with rotavirus, neurological complications are rare in this age. However, recent studies using diffusion-weighted imaging (DWI) have suggested a connection between rotavirus infection and neonatal seizures and that rotavirus infection can induce diffuse white matter injury without direct invasion of the central nervous system. The clinical features of white matter injury in rotavirus-infected neonates include the onset of seizures at days 4–6 of life in apparently healthy term infants. The recent findings seem to contradict the conventional wisdom. However, white matter injury might not be a completely new aspect of rotavirus infection in neonates, considering the forgotten clinical entity of neonatal seizures, 'fifth day fits'. With increased use of DWI in neonatal seizures, we are just starting to understand connection between viral infection and white matter injury in neonates. In this review, we discuss the historical aspects of rotavirus infection and neonatal seizures. We also present the clinical features of white matter injury in neonatal rotavirus infection.

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Section: History Of Rotavirus As a Cause Of Neonatal Seizuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

White matter injury following rotavirus infection in neonates: new aspects to a forgotten entity, 'fifth day fits'?

Yeom

Park

2016

Korean J Pediatr

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“…Some reports also suggested that rotaviral infection should be considered in neonates presenting seizures accompanied by diffuse cerebral white matter lesions shown on DWMRI 3,5,6) .…”

Section: Discussionmentioning

confidence: 99%

“…Several reports have shown that rotavirus can also cause diverse central nervous system(CNS) complications such as benign convulsions with gastroenteritis, encephalopathy/encephalitis and cerebellitis 16) . Further, some reports have described diffuse cerebral white matter lesions on diffusionweighted magnetic resonance imaging (DWMRI) in neonates with rotavirusasso ciated febrile seizures, encephalopathy and encephalitis 2,3,5,6) .…”

Section: Introductionmentioning

confidence: 99%

Rotavirus-Induced Neonatal Seizures with Cerebral White Matter Abnormalities on Magnetic Resonance Imaging: A Case Report

Park

Shin

et al. 2017

Neonatal Med

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Rotavirus is a major cause of acute gastroenteritis in infancy and early childhood. Febrile seizures can occur in some infants or children exhibiting rotavirus gastroen teritis even without severe electrolyte imbalance, hypoglycemia or abnormal cere brospinal fluid (CSF) finding. Some reports have described diffuse cerebral white matter lesions on diffusionweighted magnetic resonance imaging (DWMRI) in neonates with rotavirusassociated encephalopathy/encephalitis. In this case study, a 6dayold male neonate was transferred to the neonatal intensive care unit after having a fever lasting 24 hours. On hospital day two, the seventh day after birth, the patient had his first seizure. The pregnancy and delivery were uneventful. The lab findings, including a CSF exam, were normal, but a stool antigen test for rotavirus was positive. The electroencephalography (EEG) examination result was normal. DW MRI of the brain showed bilateral symmetric diffusion restriction in the genu and splenium of the corpus callosum as well as in the periventricular white matter of the lateral ventricles. Multiple scattered highsignalintensit foci on T1weighted image/ fluidattenuated inversion recovery (FLAIR) in the periventricular white matter were also seen bilaterally. He is now 17 months old, and there were no further seizures. He did not show any neurodevelopmental delay. This case reports that the patient with rotavirusinduced neonatal seizures with cerebral white matter abnormalities on magnetic resonance imaging (MRI) showed a normal neurodevelopmental outcome on the followup.

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