Complications and Sequelae in Patients With Congenital Microcephaly Associated With Zika Virus Infection: Two-Year
Luane A Gouvea1, Marlos Martins1, Daniela Vivacqua1
128125Universidade Federal do Rio de Janeiro, v. Pedro Calmon, Rio de Janeiro, Brazil.
Insights
Long-term follow-up of children with Zika virus exposure revealed significant neurological issues. Microcephaly, global developmental delay, and epilepsy were common, with maternal drug use linked to poorer epilepsy outcomes.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Zika virus infection during pregnancy can lead to congenital Zika syndrome.
- Long-term outcomes for children exposed to Zika virus in utero remain a critical area of research.
Purpose of the Study:
- To describe the long-term follow-up of a cohort of children exposed in utero to the Zika virus.
- To evaluate variables associated with worse prognosis epilepsy in microcephalic children due to Zika virus.
Main Methods:
- Descriptive study of a cohort of microcephalic children diagnosed with Zika virus.
- Logistic regression analysis was employed to identify factors linked to epilepsy prognosis.
- Median follow-up duration was 24 months for 28 children.
Main Results:
- All participants exhibited global developmental delay; 23 developed epilepsy, with a median onset at 4 months.
- Central nervous system abnormalities were frequent, including cortical development issues (22), corpus callosum dysgenesis (13), ventriculomegaly (25), and calcifications (24).
- Maternal illicit drug use during pregnancy was significantly associated with a worse epilepsy prognosis, including severe forms like Lennox-Gastaut and West syndromes.
Conclusions:
- Children with microcephaly secondary to in utero Zika virus exposure face significant long-term complications.
- Epilepsy, global developmental delay, and spastic diplegia are prevalent issues requiring ongoing management.
- Early identification and intervention are crucial for managing the diverse neurological sequelae of congenital Zika syndrome.
Background:
We aim to describe the long term follow-up of a cohort of children exposed in utero to the Zika virus.
Methods:
Descriptive study of a cohort of microcephalic children due to Zika virus. Logistic regression was used to evaluate variables associated with worse prognosis epilepsy.
Results:
We followed 28 children (15 females), with a median follow-up of 24 months (IQR = 12-28). During the follow-up, 1 infant died. The median head circumference at birth was 29 cm (IQR = 27-31). All presented a global developmental delay. The most frequent central nervous system abnormalities were on cortical development in 22 participants; dysgenesis of corpus callosum in 13; ventriculomegaly in 25; and calcifications in 24. A total of 9 presented ocular abnormalities, 4 auditory impairment. During follow-up, 12 presented with sleep disorders, 10 with irritability, and 23 with epilepsy (2 with generalized tonic-clonic, 3 with generalized tonic-clonic and spasms, 12 with spasms, 3 tonic and spasms, and 3 motor focal and spasms). The median age at the begin of the epilepsy was 4 months (IQR = 2-10), the median number of drugs used to control the epilepsy was 2 (IQR = 2-3). Maternal illicit drug use during pregnancy was associated with worse prognosis epilepsy (Lennox-Gastaut syndrome, West syndrome, or status epilepticus). A total of 19 presented with dysphagia, 10 children required gastrostomy.
Conclusion:
Children with microcephaly due to Zika virus presented with several complications during follow-up, as epilepsy, spastic diplegia, and global developmental delay.
