PT - JOURNAL ARTICLE AU - H Leth AU - P B Toft AU - M Herning AU - B Peitersen AU - H C Lou TI - Neonatal seizures associated with cerebral lesions shown by magnetic resonance imaging AID - 10.1136/fn.77.2.F105 DP - 1997 Sep 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - F105--F110 VI - 77 IP - 2 4099 - http://fn.bmj.com/content/77/2/F105.short 4100 - http://fn.bmj.com/content/77/2/F105.full SO - Arch Dis Child Fetal Neonatal Ed1997 Sep 01; 77 AB - AIM To determine the diagnostic potential of magnetic resonance imaging (MRI) in neonatal seizures; to elucidate the aetiology, timing, and prognosis of the cerebral lesions detected. METHODS Thirty one term neonates with clinical seizures underwent ultrasonography between days 1–7 (mean 2.5 days) and a high field spin-echo MRI scan on days 1–30 (mean 8.1 days), both of which were repeated at 3 months of age. Routine investigation excluded, as far as possible, infection, haematological, and metabolic–toxic causes as causes of the neonatal seizures. RESULTS Brain abnormality was demonstrated by MRI in 68% of infants and ultrasonographically in 10%. Diffuse brain lesions (present in 29%) were associated with high mortality (58%) and morbidity (42%), whatever the aetiology. In contrast to a better short term prognosis for neonates with focal lesions where no infants died, 33 % had a handicap, and the rest were normal at a mean follow up age of 2½ years. Cerebral lesions were presumed to have antepartum origin in 43% of cases. Seizure aetiology was considered to be hypoxic–ischaemic in 35%, haemorrhagic in 26%, metabolic disturbances and cerebral dysgenesis in 16% and unknown in 23%. CONCLUSIONS MRI detected a remarkably high incidence of brain lesions in neonatal seizures. Almost half of these were of prenatal origin and pathogenesis may essentially be attributed to hypoxic and/or haemodynamic causes.