Congenital Zika Syndrome and Infantile Spasms: Case Series Study

Abstract

Recently described, the congenital Zika syndrome caused by the Zika virus has many features of other congenital infections. This case series study reports 22 infants with congenital Zika syndrome in Brazil who developed infantile spasms during their first year of life. The median age of infantile spasms onset was 4.3 (±1.4) months and ranged from 1 to 7 months. Neurologic evaluation showed that all 22 children presented severe impairment of neuropsychomotor development. A total of 18 infants had an interictal hypsarrhythmia electroencephalogram (EEG) pattern. Vigabatrin was prescribed as first-line treatment; however, only 5 patients were controlled. Steroid regimes were started for children who did not respond to vigabatrin and they are being followed. In conclusion, congenital Zika syndrome may be considered as an etiological agent of infantile spasms.

Early epilepsy in children with Zika‐related microcephaly in a cohort in Recife, Brazil: Characteristics, electroencephalographic findings, and treatment response

“…At the end of 24 months, nearly three‐quarters of the monitored children had epileptic seizures, an incidence similar to that described in other studies of children with extensive lissencephaly . Other recent studies of microcephaly cases associated with congenital ZIKV infections have reported either similar or lower rates . Two factors may underlie the difference in rates.…”

“…11,28 Other recent studies of microcephaly cases associated with congenital ZIKV infections have reported either similar 15 or lower rates. 12,13,15,16 Two factors may underlie the difference in rates. The first is the age range assessed.…”

“…Of clinical significance, lissencephaly is considered to be a major contributor to pediatric epilepsy cases for which there is an early onset of seizures that are difficult to control with the use of antiseizure medications . As lissencephaly has been a common finding among the neuroimaging of patients with CZS, it is hypothesized that there may be an increased risk for the occurrence of early epilepsy in children with Zika‐related microcephaly, as suggested in the initial cases series . Using data collected from a cohort of children born with microcephaly during the 2015‐2016 ZIKV epidemic in northeast Brazil, this study aims to (1) estimate the incidence of epilepsy during the first 24 months of life, (2) characterize the associated clinical manifestations and electrographic findings, and (3) summarize the treatment responses.…”

Síndrome de Zika congénito en la Argentina: presentación de dos casos clínicos

“…Las pruebas de laboratorio para detectar el ZIKV en forma directa -detección del ácido ribonucleico (ARN) viral por reacción en cadena de la polimerasa con transcriptasa inversa (reverse transcription polymerase chain reaction; RT-PCR, por sus siglas en inglés)-e indirecta (IgM-ELISA y PRNT) realizados a la madre y al niño permiten la confirmación del SZC. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] En el suero, el virus es detectable desde el comienzo de los síntomas, hasta el día 6 y, en la orina, a partir del día 5 hasta el día 15. La IgM es dosable a partir del día 4 y la inmunoglobulina G (IgG), a partir del día 7 del inicio de los síntomas, y ambos persistirían en el suero hasta 12 semanas.…”

Continuous epileptiform discharges during sleep as an evolutionary pattern in patients with congenital Zika virus syndrome

“…8,9 Due to the nature and severity of injuries to the CNS, epilepsy is a frequent finding and may lead to clinical deterioration. [10][11][12] Most clinical descriptions of CZVS are based on infants at an early age. At this stage of life, epilepsy occurs in 58.3%-71.4%.…”