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Magnetic Resonance Imaging and Ultrasound Injury in Preterm Infants With Seizures

Department of Pediatrics University of California, San Francisco, California, Hannah.Glass{at}ucsf.edu, Department of Neurology, University of California, San Francisco, California

Sonia L. Bonifacio, MD

Department of Pediatrics University of California, San Francisco, California

Joseph Sullivan, MD

Department of Pediatrics University of California, San Francisco, California, Department of Neurology University of California, San Francisco, California

Elizabeth Rogers, MD

Department of Pediatrics University of California, San Francisco, California

Donna M. Ferriero, MD

Department of Pediatrics University of California, San Francisco, California, Department of Neurology University of California, San Francisco, California

Ruth Goldstein, MD

Department of Radiology University of California, San Francisco, California

A. James Barkovich, MD

Department of Radiology University of California, San Francisco, California, Department of Neurology University of California, San Francisco, California, Department of Pediatrics University of California, San Francisco, California

Although the utility of magnetic resonance imaging (MRI) as a universal screening tool in preterm infants has been contested, it is increasingly used to investigate neonatal seizures. The authors evaluated 236 infants <34 weeks’ gestation at birth. Seizures were documented according to the clinical standard of care. Infants underwent MRI and head ultrasound during the neonatal period, and a neuroradiologist and ultrasonologist performed detailed reviews of the images. During the hospital course, 9 infants (3.8%) had clinical suspicion of seizures. Magnetic resonance imaging was abnormal in each case. Periventricular hemorrhagic infarct was more common in infants with seizures. Infants with seizures were more likely to have white matter injury, though the difference was not significant. Head ultrasound failed to detect the extent of brain abnormality in 8 (89%) of the infants. In this large cohort, infants with clinical suspicion of seizures had a high rate of MRI abnormalities that were not as well characterized by head ultrasound. Magnetic resonance imaging may be the study of choice for evaluating preterm infants with seizures.

Key Words: premature • seizures • magnetic resonance imaging • ultrasound

Journal of Child Neurology, Vol. 24, No. 9, 1105-1111 (2009)
DOI: 10.1177/0883073809338328


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