Apnoea in relation to neonatal temporal lobe haemorrhage.
BACKGROUND
Six term newborns presented with apnoea and temporal lobe haemorrhage.


OBJECTIVE
In this observational study, we described involvement of the limbic system in apnoeic term newborns with temporal lobe injury.


METHODS
Six term newborns presented to the neonatal care unit with apnoea within the first 2 days of life. Ultrasound (US) and MRI of the brain were obtained in the first week of life.


RESULTS
Apnoea was related to temporal lobe haemorrhage in all. During apnoeic periods four had focal epileptic activity on EEG. All lesions were detected first with US. On MRI, haemorrhages were located in the parenchyma, the subdural and/or subarachnoid space. Three haemorrhages were surrounded by infarction in the temporal lobe. In three infants hippocampus and mesial temporal cortex were affected. In two basal temporal cortex only was involved. Vascular anomalies were excluded by MRA, serial MRI or serial US with Doppler imaging.


CONCLUSIONS
Term infants with seizure associated apnoea may present with haemorrhage and/or infarction to hippocampus, mesial and basal temporal cortex. This study supports the existence and possible disruption of descending influences from the temporal cortex and/or amygdala on brainstem breathing centres in the term newborn.
Hoogstraate
Sander R
SR
Department of Radiology, Albert Schweitzer Ziekenhuis, loc Dordwijk, Dordrecht, The Netherlands. sander@hoogstraate.com
Lequin
Maarten H
MH
Huysman
Marianne A
MA
Ahmed
Sakib
S
Govaert
Paul P
PP