Acute leucoencephalopathy in neonate due to rotavirus infection
Full-term delivery. The child was normal up to 5 days. She then developed loose stools and vomiting followed by seizures.
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MRI shows symmetrical restricted diffusion in bilateral cerebral periventricular white matter, centrum semiovale, internal capsules, corpus callosum and in ventral brainstem along bilateral corticospinal tracts. These changes are not evident on T2 or FLAIR imaging. No blooming artefact is seen.
These features in the above clinical context are most suggestive of acute leucoencephalopathy due to rotavirus infection. Stool samples were positive for rotavirus.
Neonatal seizures can be due to multiple causes. Rotavirus infection in children is common, resulting in diarrhea. Neurological manifestations are less frequently seen. Neonates with history of rotavirus infection usually present with seizures or encephalopathy on day 5 (fifth day fits) of life and this may be associated with adverse neurodevelopmental outcomes of different degrees of severity. Follow-up imaging is essential.