title: Are we considering neonatal stroke early enough in our differential diagnosis?
abstract: BACKGROUND
  Neonatal stroke is an important cause of neurodisability in childhood and in later life. Delay in diagnosis is often inevitable due to the non-specific presentation, the lack of clinical signs, and not considering stroke early enough in the differential diagnosis.
  
  
  METHODS
  We report the case of a baby who initially presented with apparent newborn "jitteriness" and abnormal movements. On the background of an unremarkable birth history and negative initial investigations, the baby subsequently developed focal seizures. The diagnosis was suspected to be neonatal stroke which was later confirmed on magnetic resonance imaging.
  
  
  CONCLUSIONS
  General Movements assessment is an established useful tool used in the assessment of such babies and proves helpful in evaluating whether movements are normal or pathological, in addition to prognosticating outcome. Cranial ultrasound is a commonly employed first-line investigation, however, initial normal intracranial appearances do not exclude stroke. Magnetic resonance imaging is the gold standard but may not be immediately available to all practitioners.
authors.affiliation: Academic Unit of Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Paddock
authors.affiliation: Department of Paediatrics, Imperial College Healthcare, London, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Demetriou
authors.affiliation: Neonatal Unit, Northwick Park Hospital, Harrow, Middlesex, United Kingdom.
authors.forename: R
authors.initials: R
authors.lastname: Nicholl
mesh_terms: D003937:Diagnosis, Differential; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D009068:Movement / Q000502:physiology; D012640:Seizures / Q000209:etiology; D020521:Stroke / Q000150:complications / Q000175:diagnosis*
keywords: Jittery; abnormal movement; jitteriness; neonatal stroke; seizure