Achados clínicos, neurofisiológicos e de neuroimagem em crianças com microcefalia associada à infecção congênita pelo vírus Zika

Abstract

Zika virus (ZIKV) infection in humans was first documented in Brazil in 2015, causing an epidemic and being associated with serious neurological disorders in the fetus. Objective: To describe the clinical, neurophysiological and neuroimaging findings of children with microcephaly associated with congenital ZIKV infection. Study design: Study retrospective, descriptive and cross-sectional. Methods: Review of electronic medical records of children with congenital microcephaly, whose mothers were exposed to ZIKV during pregnancy and received at a child rehabilitation center in Salvador - Brazil, evaluated by an interdisciplinary team following standardized procedures and investigating other congenital infections correlated. Results: Of the 102 children evaluated, 81% of mothers reported symptoms of ZIKV in the 1st trimester of pregnancy; 54% of children had severe microcephaly; and all children at a mean age of 4.6 months (2.6 SD) had brain abnormalities in the findings of neuroimaging, the most frequent being: cerebral atrophy (92.1%), ventriculomegaly (92.1%), malformation of cortical development (85.1%) and cortico-subcortical calcifications (80.2%). Anomalies were also found in neurological examinations (97.0%), the most common being hypertonia/spasticity (97.0%), neurodevelopmental delay (92.8%) and hyperreflexia (73.3%); the abnormal results of neurophysiological exams showed epileptogenic activity in 56.3% of cases, hearing impairment in 17.3% and visual impairment in 14.1%; the arthrogryposis was detected in 10.8% of children. Conclusion: This group of children presented clinical criteria and neuroimaging for congenital ZIKV infection syndrome (CZS), with high frequency of brain abnormalities and early-onset neurological manifestations; thus suggesting that microcephaly may be associated with a more severe spectrum of SCZ-related neurological manifestations.