Pediatric Periventricular Leukomalacia Clinical Presentation

Updated: Dec 08, 2020
  • Author: Renjithkumar Kalikkot Thekkeveedu, MD; Chief Editor: Santina A Zanelli, MD  more...
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Periventricular leukomalacia (PVL) occurs most commonly in premature infants born at less than 32 weeks' gestation who have a birth weight below 1500 g. Many of these infants have a history of maternal chorioamnionitis. Most affected infants experience cardiorespiratory problems, such as respiratory distress syndrome or pneumonia, in association with hypotension or patent ductus arteriosus during their first days of life. Bacterial infection at birth also appears to be a risk factor.


Physical Examination

Initially, most premature infants with periventricular leukomalacia (PVL) are asymptomatic. If symptoms occur, they are usually subtle.

Symptoms of periventricular leukomalacia may include the following:

  • Decreased tone in the lower extremities

  • Increased tone in the neck extensor muscles

  • Apnea and bradycardia events

  • Irritability

  • Pseudobulbar palsy with poor feeding

  • Clinical seizures (may occur in 10-30% of infants)