Work

Symmetrical Thalamic Lesions in Preterm Triplets: What Can We Learn From the Different Phenotypes?

Year: 2025

Type: article

Abstract: BACKGROUND: Symmetrical thalamic lesions (STL) is a rare condition that affects term newborns who have suffered an antenatal hypoxic insult and present at birth with specific clinical features: feeding and swallowing difficulties, facial hypomimia, apnea, and frequently hypertonia. Recently STL have also been described in preterm infants. CASE DETAILS: We describe the first case series of STL in preterm triplets with a variable spectrum of clinical outcomes, following a clearly identified perinatal anoxic insult. Spontaneous male triplets, two monochorionic-diamniotic (T1 and T2) and one dichorionic-diamniotic (T3), were born at 31 1/7 gestational weeks by emergency Caesarean section due to maternal anaphylactic shock and presented with severe neonatal asphyxia. CONCLUSIONS: The clinical presentation, neuroimaging studies, and autoptic findings of the two monochorionic twins are compatible with STL with a more severe neurological presentation of T1. The dichorionic triplet was completely unaffected. Genetic and metabolic studies excluded alternative etiologies.

Source: Pediatric Neurology

DOI: 10.1016/j.pediatrneurol.2025.06.012