Neurodevelopmental outcomes in newborns with neonatal seizures caused by rotavirus-associated leukoencephalopathy

Seizure. 2018 Mar;56:14-19. doi: 10.1016/j.seizure.2018.01.023. Epub 2018 Feb 7.

Abstract

Purpose: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: Diffusion magnetic resonance imaging; Leukoencephalopathy; Newborn; Prognosis; Rotavirus; Seizures.

MeSH terms

  • Electroencephalography
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted
  • Infant
  • Infant, Newborn
  • Leukoencephalopathies / complications*
  • Leukoencephalopathies / diagnostic imaging
  • Leukoencephalopathies / virology
  • Magnetic Resonance Imaging
  • Male
  • Neurodevelopmental Disorders / diagnostic imaging
  • Neurodevelopmental Disorders / etiology*
  • Neurologic Examination
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Rotavirus / pathogenicity
  • Rotavirus Infections / complications*
  • Rotavirus Infections / diagnostic imaging
  • Seizures* / complications
  • Seizures* / etiology
  • Seizures* / virology