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KMID : 1103720200810061412
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Journal of the Korean Society of Radiology
2020 Volume.81 No. 6 p.1412 ~ p.1423
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Clinical and Imaging Findings of Neonatal Seizures Presenting as Diffuse Cerebral White Matter Abnormality on Diffusion-Weighted Imaging without any Structural or Metabolic Etiology
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Kim Mae-Ran
Hwang Jae-Yeon
Lee Yeoun-Joo
Kim Yong-Woo
Byun Shin-Yun
Lee Yun-Jin
Yeom Jeong-A
Jeon Ung-Bae
Choo Ki-Seok
Nam Kyung-Jin
Reid Storm Nicholas Shaun
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Abstract
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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.
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KEYWORD
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Infant, Newborn, Rotavirus, Diffusion Magnetic Resonance Imaging
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