Objective: Some viruses can cause neonatal seizures accompanied by diffuse cerebral white matter injury.^1-3 The purpose of this study is to identify the viral causes of seizures and diffuse cerebral white matter lesions in full-term newborns, and describe the clinical characteristics.

Methods: Twenty-two full-term newborns with seizures accompanied by bilateral diffuse cerebral white matter lesions on diffusion-weighted imaging (DWI) of brain MRI were admitted to our hospital between 2011 and 2012. We retrospectively review the records of 15 of these patients who tested positive for parechovirus, enterovirus, or rotavirus using real-time reverse transcription polymerase chain reaction. Specimens for examination were the stool in 15 patients, serum in 12 patients, and cerebrospinal fluid (CSF) in 11 patients.

Results: Rotavirus was detected in all 15 stool specimens, but not in the serum and CSF. Parechovirus and enterovirus were not identified in any specimens. The rotavirus genotype identified in the stool was G4P6 in each of the 15 patients, who were all healthy prior to seizure onset. Their 1- and 5-min Apgar scores ranged between 7 and 9. The patients’ age at seizure onset was 4.4±0.7 days (range, 3–6 days). In the three-month follow-up brain MRIs, 8 of 13 patients showed no specific abnormalities. The other 5 patients, however, demonstrated cystic changes or atrophic changes in the cerebral white matter.

Conclusions: Rotavirus infection should be considered in newborns with seizures accompanied by diffuse cerebral white matter lesions on DWI, particularly around 5 days of life.