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PEDIATRICS Vol. 100 No. 4 October 1997, p. e8
Copyright ©1997 by the American Academy of Pediatrics

ELECTRONIC ARTICLE:
An Unusual Cause of Neonatal Seizures in a Newborn Infant

Received Dec 2, 1996; accepted Feb 15, 1997.

O. L. de Klerk

T. W. de Vries

Department of Pediatrics Leeuwarden Medical Centre Leeuwarden, The Netherlands

L. G. F. Sinnige

Department of Neurology Leeuwarden Medical Centre Leeuwarden, The Netherlands

Neonatal seizures in the neonatal period are symptoms of numerous underlying disorders of the neonate. We present a case in which neonatal seizures due to cerebral infarction led to a diagnosis in the mother.

Neonatal convulsions caused by cerebral artery thrombosis is relatively rare in the neonatal period and is often secondary to indwelling intravascular catheters that cause thromboembolism, but may be associated with many conditions.1

Cerebral artery thrombosis in newborns, in which antiphospholipid antibodies (APA) were found in the mother, has been described in three case reports. Two of these premature infants were born with other risk factors for thrombosis. APA could not be identified in any of these three infants. In the two cases reported by Silver et al the diagnosis was made several months after birth.

This case is unique in the fact that no other risk factors for thrombosis could be identified to explain the infarction, and that APA were found in the offspring of an apparently healthy mother. Whether the prior fetal death was caused by APA remains unclear. The finding of lupus anticoagulant in her child led to the diagnosis of antiphospholipid antibody syndrome in her. We believe that in case of cerebral artery thrombosis in a neonate, with no trivial cause such as an indwelling catheter or sepsis, both mother and infant should be tested for presence of APA, even when the mother seems healthy.

Key words: neonate, cerebral infarction, maternal antiphospholipid syndrome.