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Dr. Andrew Rynne

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What does my ultrasound scan report indicate?

Answered by
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Dr. Pradeep Kumar

Pediatrician, Cardiology

Practicing since :2006

Answered : 1829 Questions

Question
Hi,
My neice (age-one month old) was suffering from cold and cough from last week and she had an Seizure(Fits) on Sunday afternoon, we admitted her in a hospital. She is in NICU now and she was put on ventilator for almost oneday (doctors said that her heart rate is below normal) and she was injected with Antibiotic and Anti-Viral medications.

Doctors took Ultrasound scan and observed no internal bleeding symptoms in brain. Now they are planning to go for an MRI scan and later Lumbar Puncture if need be.

Now her heart rate is back to normal and not on any oxygen/ventilator. could you please clarify the below concerns.

1. Is it safe to take MRI scan for one month old baby?
2. Will there be any adverse effects due to MRI scan? any other alternative procedure?

Note: Baby was born healthy.
Fri, 5 Jan 2018 in Child Health
 
 
Answered by Dr. Pradeep Kumar 58 minutes later
Brief Answer:
MRI is safe for neonate

Detailed Answer:
Hi

Thanks for asking on this platform

I have gone through the query and do understand your concern.
There can be so many causes of seizure right from low blood sugar, low calcium level, infection to any brain disorder like bleeding, tumor, any structural abnormality of brain.
MRI is very safe and is of high diagnostic value in all age groups including the newborn period. There is no radiation hazard with MRI in comparison to X-ray and CT scan.
It is always better to rule out any brain abnormality for early detection, intervention and also for long term prognostication(outcome).
You may not find any abnormality in MRI and in that case the comparative outcome is better.
Ultrasound brain is other safe modality which is already done.
So you can go for MRI brain safely.

I hope this helps.
Please let me know if you have any more questions.
Regards
Above answer was peer-reviewed by
 
Follow-up: What does my ultrasound scan report indicate? 17 hours later
Thanks for the information, I have few more queries.

1. how does the seizure effect on heart rate? does it increases or decreases the hr?
2. does anti-seizure medications have any effect on heart rate? how does it work?
 
 
Answered by Dr. Pradeep Kumar 1 hour later
Brief Answer:
Seizure and medications have variable affects on heart rate

Detailed Answer:
Hi

In medical science there are various possibilities in different situation and one has to correlate all the findings to each other.
In seizure there can be increased heart rate or decreased heart rate.
Even abnormally increased or decreased heart rate can also present with seizure.
The more common finding is increased heart rate with seizure. One has to look the cause of seizure as if seizure is due to low sugar or low calcium there can be low heart rate due to sugar and calcium level per se and not due to seizure. Similarly in brain infection there can be low heart rate due to increase in pressure in brain and infection itself may cause seizure.
Some cardiac conduction abnormality can present with seizure like long QT syndrome.
So in summary by saying that whether seizure causes increased or decreased heart rate will not solve the issue. A multisystem approach is needed.
There are few medications of seizure which can affect heart rate like Phenytoin may cause decreased heart rate by acting on electrical conducting system of heart.


Regards
Above answer was peer-reviewed by
 
Follow-up: What does my ultrasound scan report indicate? 7 hours later
Hi doctor.

The my niece report is as below:

Blood test report is normal.
Ultrasound brain is fine, no structural problem.
They took MRI brain today and it is also fine.

No issues are observed.

The pediatrician is now thinking to do LP, is lumbar puncture really required for 1month old baby??
No convulsions has been observed after Sunday's episode.

Please suggest if LP is required or not?

Really appreciate for your time and suggestions.
 
 
Answered by Dr. Pradeep Kumar 5 hours later
Brief Answer:
Please reattach the report

Detailed Answer:
Hi

I am sorry but I did not find the attached report.So I request you to reattach the report.
During initial month of life the infection in the brain should always be ruled out in case of seizure if there is any suspicion. MRI brain usually rules out any structural abnormality although it can show the changes due to infection(meningitis)also.
Lumber puncture is very specific to detect any brain infection. It is needed as the duration of antibiotic treatment is more in case of bacterial brain infection.
As the baby has already received the antibiotics the lumber puncture study may not be very suggestive(ideally it should be done before starting the antibiotics).
Again the final decision depends on the treating clinician.
Personally I feel although it would have been better if lumber puncture was done during initial days,even then you should go for the test.If it comes negative you should be assured that there is nothing serious and if it is suggestive or doubtful then the baby may need complete course of antibiotics.

Regards

Above answer was peer-reviewed by
 
Follow-up: What does my ultrasound scan report indicate? 10 hours later
Hi Doctor,

The doctors yesterday told lumbar puncture is not needed and they said the baby had got pneumonia and she is recovering and are planning to shift her today to General ward from NICU.

can pneumonia also cause seizure?Is it febrile seizure?
 
 
Answered by Dr. Pradeep Kumar 2 hours later
Brief Answer:
Unlikely to be febrile seizure

Detailed Answer:
Hi

Pneumonia which is primarily an infection of lungs itself does not causes seizure. But associated factors like hypoglycemia, hypoglycemia, other electrolyte abnormalities or decreased oxygen supply to brain may cause seizures.
Once the structural abnormalities(by MRI and USG brain), brain infection is being ruled out;EEG (a test to check electrical activities in brain) can be done to rule out seizure disorder(unlikely in this age) .
Based on EEG one can decide whether the seizure medications need to be given for long term or not. If EEG test is positive long term seizure medication is needed but if it is negative one can try to withhold the medication considering that the episode of seizure was due to some transient abnormality.
Febrile seizure is unlikely in this age. Febrile seizure is usually seen in babies more than 3 months of age and when there is no other associated significant comorbities.

It is good to know that baby is doing well. My all best wishes with you.
Praying for his early recovery.
I shall be glad to help further if you need any.
With regards
Above answer was peer-reviewed by
 
Follow-up: What does my ultrasound scan report indicate? 21 minutes later
Thanks alot Doctor!

All the information and your opinion is very helpful.
 
 
Answered by Dr. Pradeep Kumar 15 minutes later
Brief Answer:
My pleasure sir

Detailed Answer:
It's my pleasure that you found my suggestions helpful.
Please let me know anytime if you have any query.
Thanks
Above answer was peer-reviewed by
 
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