Delayed onset of status epilepticus after transient asphyxia in an asymptomatic full-term neonate.
A full-term neonate presented with status epilepticus at 12 hours of age after a symptom-free interval following transient asphyxia at birth. Conventional neuroimaging failed to detect structural correlates to support recent injury. However, diffusion-weighted magnetic resonance imaging studies revealed recent ischemic brain injury. Placental examination documented multiple subacute and chronic findings indicative of decreased maternal/fetal perfusion. These antepartum placental abnormalities may have been associated with this child's inability to withstand the stress of a prolonged second stage of labor, resulting in intrapartum asphyxia leading to brain injury. This child's clinical presentation highlights the delayed reperfusion phase after ischemia-induced brain injury.
Scher
Mark S
MS
Department of Pediatrics, Division of Pediatric Neurology, Rainbow Babies and Children's Hospital, Cleveland, Ohio 44106-6090, USA. mss20@po.cwru.edu
Redline
Raymond W
RW
Bangert
Barbara A
BA
D001237:Asphyxia / Q000150:complications* / Q000209:etiology*; D001720:Birth Injuries / Q000150:complications / Q000209:etiology; D001930:Brain Injuries / Q000209:etiology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010920:Placenta / Q000473:pathology; D010922:Placenta Diseases / Q000150:complications*; D021041:Placental Circulation; D011247:Pregnancy; D013226:Status Epilepticus / Q000209:etiology*