Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Seizure. 2018 Mar;56:14-19. doi: 10.1016/j.seizure.2018.01.023. Epub 2018 Feb 7.
Rotavirus infection has recently been reported to be associated with seizures accompanied by leukoencephalopathy in newborns. We aimed to determine long-term outcomes and prognostic factors in newborns with neonatal seizures caused by rotavirus-associated leukoencephalopathy.
We retrospectively reviewed the records and brain magnetic resonance (MR) images of 32 patients who fulfilled the following criteria: (1) neonatal seizures, (2) distinctive symmetric cerebral white matter lesions on diffusion-weighted MR images (DWI), (3) rotavirus infection, (4) absence of a specific etiology of seizures, except for the aforementioned DWI lesions, and (5) Korean Bayley Scales of Infant Development II (K-BSID-II) assessment after 12 months of age.
The mean age at seizure onset was 4.7 ± 0.8 days. The median age of the patients at the time of K-BSID-II assessment was 22 months. Fourteen patients (43.8%) showed normal or accelerated performance in the mental and motor scales, while 18 patients (56.2%) had delayed performance in the mental and/or motor scales. Seven patients (21.9%) had significantly delayed performances on the mental and/or motor scales. The percentage of volume of diffusion-restricted lesions based on total brain volume was significantly negatively correlated with the mental developmental index (MDI) score (r = -0.507, p = .003), but not with the psychomotor developmental index (PDI) score (r = -0.324, p = .071).
Rotavirus-associated leukoencephalopathy in newborns around 5 days of age can cause adverse neurodevelopmental outcomes with a wide range of severity. The extent of white matter lesion on initial DWI can predict neurocognitive outcome.
最近有报道称，轮状病毒感染与新生儿伴有白质脑病的癫痫发作有关。我们旨在确定由轮状病毒相关的白质脑病引起的新生儿癫痫发作的新生儿的长期预后和预测因素。
我们回顾性地分析了 32 名符合以下标准的患者的病历和脑磁共振（MR）图像：（1）新生儿癫痫发作，（2）弥散加权 MR 图像（DWI）上有特征性对称的大脑白质病变，（3）轮状病毒感染，（4）除了上述 DWI 病变外，癫痫发作没有特定的病因，（5）12 个月后进行韩国贝利婴幼儿发育量表第二版（K-BSID-II）评估。
癫痫发作的平均发病年龄为 4.7±0.8 天。患者进行 K-BSID-II 评估时的中位年龄为 22 个月。14 名患者（43.8%）在精神和运动量表上表现正常或加速，而 18 名患者（56.2%）在精神和/或运动量表上表现延迟。7 名患者（21.9%）在精神和/或运动量表上的表现明显延迟。基于全脑体积的弥散受限病变体积百分比与精神发育指数（MDI）评分呈显著负相关（r=-0.507，p=0.003），但与精神运动发育指数（PDI）评分无显著相关性（r=-0.324，p=0.071）。
5 天龄左右的新生儿轮状病毒相关性白质脑病可引起严重程度不一的不良神经发育结局。初始 DWI 上的白质病变程度可预测神经认知结局。
