Fetal seizure is a very rare prenatal finding and associated with an almost invariably poor outcome, the most common causes being hypoxic-ischemic encephalopathy, congenital anomalies of either the central nervous system (CNS) or musculoskeletal system, and metabolic disorders. The prenatal detection of seizure-like activity in fetuses with congenital infection has not been previously reported. In this report, we describe 3 cases of seizures in fetuses with congenital infection including Zika virus (n = 2) and toxoplasmosis (n = 1). All 3 fetuses had associated CNS abnormalities and the perinatal outcome was uniformly poor. This report suggests that for fetuses with proven congenital infections an extended and targeted sonographic examination may be helpful in -detecting associated fetal seizures that may even worsen the neonatal outcome.

1.
de Vries
JI
,
Visser
GH
,
Prechtl
HF
.
The emergence of fetal behaviour. I. Qualitative aspects
.
Early Hum Dev
.
1982
Dec
;
7
(
4
):
301
22
.
[PubMed]
0378-3782
2.
de Vries
JI
,
Visser
GH
,
Prechtl
HF
.
The emergence of fetal behaviour. II. Quantitative aspects
.
Early Hum Dev
.
1985
Nov
;
12
(
2
):
99
120
.
[PubMed]
0378-3782
3.
Prechtl
HFR
.
Qualitative changes of spontaneous movements in fetus and preterm infant are a marker of neurological dysfunction.
Early Hum Dev
1990
; 23:151−158.
4.
Roodenburg
PJ
,
Wladimiroff
JW
,
van Es
A
, et al
Classification and quantitative aspects of fetal movements during the second half of normal pregnancy.
Early Hum Dev
1991
; 25:19−35.
5.
Sival
DA
,
Visser
GHA
,
Prechtl
HFR
.
The effect of intrauterine growth retardation on the quality of general movements in the human fetus.
Early Hum Dev
1992
; 28:119−132.
6.
Sival
DA
.
Studies on fetal motor behaviour in normal and complicated pregnancies.
Early Hum Dev
1993
; 34:13−20.
7.
Hayat
TT
,
Martinez-Biarge
M
,
Kyriakopoulou
V
,
Hajnal
JV
,
Rutherford
MA
.
Neurodevelopmental Correlates of Fetal Motor Behavior Assessed Using Cine MR Imaging
.
AJNR Am J Neuroradiol
.
2018
Aug
;
39
(
8
):
1519
22
.
[PubMed]
0195-6108
8.
Usta
IM
,
Adra
AM
,
Nassar
AH
.
Ultrasonographic diagnosis of fetal seizures: a case report and review of the literature.
BJOG
2007
; 114:1031−1033.
9.
Bejsovec
MIR
,
Kulenda
Z
,
Ponca
E
.
Familial intrauterine convulsions in pyridoxine dependency.
Arch Dis Child
1967
; 42:201−207.
10.
Westgate
JA
,
Bennet
L
,
Gunn
AJ
.
Fetal seizures causing increased heart rate variability during terminal fetal hypoxia.
Am J Obstet Gynecol
1999
; 181:765−766.
11.
de Vries
JI
.
Ultrasonographic diagnosis of fetal seizures: a case report and review of the literature
.
[letter]
.
BJOG
.
2008
Jan
;
115
(
1
):
129
30
.
[PubMed]
1470-0328
12.
de Vries
JIP
,
Fong
BF
.
Changes in fetal motility as a result of congenital disorder: an overview.
Ultrasound Obstet Gynecol
2007
; 29:590−599.
13.
du Plessis
AJ
,
Kaufmann
WE
,
Kupsky
WJ
.
Intrauterine-onset myoclonic encephalopathy associated with cerebral cortical dysgenesis
.
J Child Neurol
.
1993
Apr
;
8
(
2
):
164
70
.
[PubMed]
0883-0738
14.
Keogh
JM
,
Badawi
N
,
Kurinczuk
JJ
,
Dixon
G
, et al
Maternal awareness of fetal seizures in pregnancies resulting in newborn encephalopathy.
Acta Obstet Gynecol Scand
2000
; 79:787−789.
15.
Hobson
EE
,
Thomas
S
,
Crofton
PM
, et al
Isolated sulphite oxidase deficiency mimics the features of hypoxic ischaemic encephalopathy.
Eur J Pediatr
2005
; 164:655−659.
16.
Patel
MS
,
Becker
LE
,
Toi
A
,
Armstrong
DL
,
Chitayat
D
.
Severe, fetal-onset form of olivopontocerebellar hypoplasia in three sibs: PCH type 5?
Am J Med Genet A
.
2006
Mar
;
140
(
6
):
594
603
.
[PubMed]
1552-4825
17.
Sheizaf
B
,
Mazor
M
,
Landau
D
,
Burstein
E
,
Bashiri
A
,
Hershkovitz
R
.
Early sonographic prenatal diagnosis of seizures.
Ultrasound Obstet Gynecol
2007
; 30:1007−1009.
18.
Jung
E
,
Lee
BY
,
Huh
CY
.
Prenatal diagnosis of fetal seizure: a case report
.
J Korean Med Sci
.
2008
Oct
;
23
(
5
):
906
8
.
[PubMed]
1011-8934
19.
Ruiz
A
,
García-Villoria
J
,
Ormazabal
A
,
Zschocke
J
,
Fiol
M
,
Navarro-Sastre
A
, et al
A new fatal case of pyridox(am)ine 5′-phosphate oxidase (PNPO) deficiency
.
Mol Genet Metab
.
2008
Feb
;
93
(
2
):
216
8
.
[PubMed]
1096-7192
20.
Darin
N
,
Reid
E
,
Prunetti
L
,
Samuelsson
L
,
Husain
RA
,
Wilson
M
, et al
Mutations in PROSC disrupt cellular pyridoxal phosphate homeostasis and cause vitamin-B6-dependent epilepsy
.
Am J Hum Genet
.
2016
Dec
;
99
(
6
):
1325
37
.
[PubMed]
0002-9297
21.
McNally
MA
,
Johnson
J
,
Huisman
TA
, et al
SCN8A epileptic encephalopathy: detection of fetal seizures guides multidisciplinary approach to diagnosis and treatment.
Pediatr Neurol
2016
; 64:87−91.
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