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Neuropediatrics 2020; 51(01): 062-067
DOI: 10.1055/s-0039-1695712
Short Communication
Georg Thieme Verlag KG Stuttgart · New York

Rotavirus-Induced Neonatal Epileptic Encephalopathy—A Disease Spectrum Illustrated by Monochorionic Twins

Esther M. Hopmans 
1   Department of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Leiden, The Netherlands
,
Astrid van der Heide
1   Department of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Leiden, The Netherlands
2   Department of Neurology and Neurosurgery, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
,
Pui Khi Chung
3   Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
,
Daniëlle Brinkman
4   Department of Paediatrics, Alrijne Hospital, Leiderdorp, The Netherlands
,
Mariet C.W. Feltkamp
3   Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
,
J. Gert van Dijk
1   Department of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Leiden, The Netherlands
,
Sylke J. Steggerda
5   Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
,
Erik H. Niks 
1   Department of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Leiden, The Netherlands
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Further Information

Publication History

20 December 2019

12 July 2019

Publication Date:
21 September 2019 (online)

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Abstract

Rotavirus has been associated with neonatal seizures and specific white matter magnetic resonance imaging (MRI) abnormalities. We describe monochorionic twins who not only tested positive for rotavirus with these white matter MRI abnormalities but who also showed an electroencephalogram (EEG) pattern characteristic of early infantile epileptic encephalopathy (EIEE), which has so far solely been described in epileptic encephalopathies with a poor prognosis. This report suggests that rotavirus infection must be added to the list of causes of EIEE EEG, and that the outcome then is likely more favorable. As MRI and EEG signs of rotavirus encephalopathy were present in one twin with only subtle neurologic symptoms, rotavirus may well cause insidious central nervous system complications more often. We suggest considering rotavirus infection in neonates presenting with seizures, and to add rotavirus infection to the differential diagnosis of EIEE.

Keywords

neonatal seizures - rotavirus - epileptic encephalopathy - EIEE - MRI

What This Paper Adds

• The EEG pattern of early epileptic encephalopathy in neonates can occur in rotavirus-associated encephalopathy


• Rotavirus-associated encephalopathy can present with very subtle clinical signs


 

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