Neuropediatrics 2019; 50(03): 152-159
DOI: 10.1055/s-0039-1683864
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Symmetrical Thalamic Lesions in the Newborn: A Case Series

T. Pols
1   Department of Neonatology, Isala Women and Children's Hospital, Zwolle, The Netherlands
2   Department of Neonatology, Maxima Medical Center, Veldhoven, The Netherlands
,
L.S. de Vries
3   Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
,
A. Soltirovska Salamon
4   Department of Neonatology, University Children's Hospital, University Medical Center, Ljubljana, Slovenia
,
P.G.J. Nikkels
5   Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
,
K.D. Lichtenbelt
6   Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
,
S.M. Mulder-de Tollenaer
1   Department of Neonatology, Isala Women and Children's Hospital, Zwolle, The Netherlands
,
G. van Wezel-Meijler
1   Department of Neonatology, Isala Women and Children's Hospital, Zwolle, The Netherlands
› Author Affiliations
Further Information

Publication History

14 August 2018

08 February 2019

Publication Date:
26 March 2019 (online)

Abstract

Although bilateral injury to the thalami is often seen in (near)term infants with hypoxic ischemic encephalopathy (HIE), symmetrical thalamic lesions (STL) is a different, very rare condition, seen both in full-term and preterm infants often after an antenatal insult, although the history is not always clear. These lesions are usually first detected using cranial ultrasound (cUS). They may not always be seen on the first (admission) scan, but become apparent in the course of the 1st week after birth. Clinically, these infants present with hypo- or hypertonia, absence of sucking and swallowing reflexes, and they may have contractures and facial diplegia. Neuropathology commonly demonstrates a thalamic lesion with additional and variable involvement of basal ganglia and brainstem. The prognosis is very poor, the condition often leads to severe disabilities and/or death within the first years of life. The clinical course and neuroimaging findings of 13 patients with symmetrical thalamic lesions (STL) are reported.

Note

A statement of the location where the work was performed: this work has been performed at the NICU of Isala Women and Children's Hospital in close collaboration with two other European institutions.


 
  • References

  • 1 Rosales RK, Riggs HE. Symmetrical thalamic degeneration in infants. J Neuropathol Exp Neurol 1962; 21: 372-376
  • 2 Peters B, Walka MM, Friedmann W, Stoltenburg-Didinger G, Obladen M. Hypoxic-ischemic encephalopathy with cystic brain stem necroses and thalamic calcifications in a preterm twin. Brain Dev 2000; 22 (04) 265-271
  • 3 Buldini B, Drigo P, Via LD, Calderone M, Laverda AM. Symmetrical thalamic calcifications in a monozygotic twin: case report and literature review. Brain Dev 2005; 27 (01) 66-69
  • 4 Bordarier C, Moktari M, Rodriguez D, Adamsbaum C, Robain O. Antenatal thalamic lesions in the newborn: two anatomoclinical cases. Brain Dev 1997; 19 (07) 495-498
  • 5 Counsell SJ, Maalouf EF, Fletcher AM. , et al. MR imaging assessment of myelination in the very preterm brain. AJNR Am J Neuroradiol 2002; 23 (05) 872-881
  • 6 Peleg D, Nelson GM, Williamson RA, Widness JA. Expanded Möbius syndrome. Pediatr Neurol 2001; 24 (04) 306-309
  • 7 Logitharajah P, Rutherford MA, Cowan FM. Hypoxic-ischemic encephalopathy in preterm infants: antecedent factors, brain imaging, and outcome. Pediatr Res 2009; 66 (02) 222-229
  • 8 van Wezel-Meijler G, Leijser LM, Wiggers-de Bruïne FT, Steggerda SJ, van der Grond J, Walther FJ. Diffuse hyperechogenicity of basal ganglia and thalami in preterm neonates: a physiologic finding?. Radiology 2011; 258 (03) 944-950
  • 9 Roland EH, Poskitt K, Rodriguez E, Lupton BA, Hill A. Perinatal hypoxic-ischemic thalamic injury: clinical features and neuroimaging. Ann Neurol 1998; 44 (02) 161-166
  • 10 Natsume J, Watanabe K, Kuno K, Hayakawa F, Hashizume Y. Clinical, neurophysiologic, and neuropathological features of an infant with brain damage of total asphyxia type (Myers). Pediatr Neurol 1995; 13 (01) 61-64
  • 11 Eicke M, Briner J, Willi U, Uehlinger J, Boltshauser E. Symmetrical thalamic lesions in infants. Arch Dis Child 1992; 67 (1, Spec No): 15-19
  • 12 Leech RW, Alvord Jr EC. Anoxic-ischemic encephalopathy in the human neonatal period. The significance of brain stem involvement. Arch Neurol 1977; 34 (02) 109-113
  • 13 Myers RE. Four patterns of perinatal brain damage and their conditions of occurrence in primates. Adv Neurol 1975; 10: 223-234
  • 14 Parisi JE, Collins GH, Kim RC, Crosley CJ. Prenatal symmetrical thalamic degeneration with flexion spasticity at birth. Ann Neurol 1983; 13 (01) 94-97
  • 15 Abuelo DN, Barsel-Bowers G, Tutschka BG, Ambler M, Singer DB. Symmetrical infantile thalamic degeneration in two sibs. J Med Genet 1981; 18 (06) 448-450
  • 16 DiMario Jr FJ, Clancy R. Symmetrical thalamic degeneration with calcifications of infancy. Am J Dis Child 1989; 143 (09) 1056-1060
  • 17 Gorman KM, Aird JJ, Conroy J, Devaney D, Farrell M, King MD. Symmetrical thalamic calcification: A trio whole exome sequencing negative series. Brain Dev 2017; 39 (05) 426-430
  • 18 Banerjea MC, Speer CP. Bilateral thalamic lesions in a newborn with intrauterine asphyxia after maternal cardiac arrest--a case report with literature review. J Perinatol 2001; 21 (06) 405-409