Extensive hemicerebral damage after traumatic midterm amniocentesis


A 28-year-old right-handed man had suffered a traumatic amniocentesis at 17 weeks’ gestation, and subsequently was born with extensive right-sided cerebral, cerebellar and brainstem damage. The initial amniocentesis had been abandoned and was repeated 2 weeks later, with normal results; subsequent prenatal ultrasound scans were normal. The patient had an uncomplicated delivery at term, though was noted to have a complete right-sided ptosis and marks on the right parietal region of the scalp. By 4 months of age, it was evident that he had developed a right-sided third nerve palsy, a left-sided hemiparesis and left visual field defect. He developed infantile spasms that were treated successfully with adrenocorticotrophic hormone (ACTH). No further seizures occurred until habitual seizures began at 7 years of age, consisting of focal seizures with and without loss of awareness, with blank spells, abdominal discomfort, head turning, agitation and disorientation. Although initially controlled with antiseizure medication,…

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