Article in Japanese
Congenital cytomegalovirus infection retrospectively diagnosed following onset of epilepsy in early childhood: A case report
Sayako YAMAOKA1), Keiichi SHIGEHARA1), Kazutaka OUCHI1)
Congenital cytomegalovirus (CMV) infection is often asymptomatic in the prenatal period and at birth, and remains undiagnosed in the neonatal period. However, it may result in neurological disorders later in life, such as hearing loss, intellectual disabilities, and epilepsy. This study describes a case of retrospective diagnosis of congenital CMV infection that was complicated with epilepsy in an infant, without hearing loss or intellectual disability.
A male infant aged 29 months was admitted to this hospital with impaired consciousness following generalized tonic-clonic seizures. Electroencephalography revealed high-voltage, slow wave activity in the posterior region. Brain magnetic resonance imaging showed abnormal bilateral signals in the periventricular and subcortical white matter. As acute disseminated encephalomyelitis could not be ruled out, one course of steroid pulse therapy was administered, which did not resolve the white matter lesions. The patient was examined carefully for signs of leukodystrophy and diagnosed with congenital CMV infection after performing amplification of CMV DNA, using dried umbilical cord cells and dried blood spots obtained at birth.
Congenital CMV infection has a broad spectrum of nonspecific clinical symptoms, and therefore, its differentiation from other neurologic diseases is often difficult. The finding in this study emphasizes that congenital CMV infection should be considered in the differential diagnosis if abnormal white matter lesions are found, even if typical symptoms are absent.
1) Department of Pediatrics, Ayabe City Hospital
|Key words||congenital cytomegalovirus infection, epilepsy, abnormal white matter lesions, dried umbilical cord, dried blood spots|
|Received||February 4, 2020|
|Accepted||April 15, 2020|