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

ABSTRACT

Rotavirus is a major cause of acute gastroenteritis in infancy and early childhood. Febrile seizures can occur in some infants or children exhibiting rotavirus gastroenteritis even without severe electrolyte imbalance, hypoglycemia or abnormal cerebrospinal fluid (CSF) finding. Some reports have described diffuse cerebral white matter lesions on diffusion-weighted magnetic resonance imaging (DW-MRI) in neonates with rotavirus-associated encephalopathy/encephalitis. In this case study, a 6-day-old 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 high-signal-intensit foci on T1-weighted image/fluid-attenuated 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 rotavirus-induced neonatal seizures with cerebral white matter abnormalities on magnetic resonance imaging (MRI) showed a normal neurodevelopmental outcome on the follow-up.