Title : Neurological development, Epilepsy, And the pharmacotherapy approach in children with congenital zika syndrome: Results from a two-year follow-up study
Abstract:
Introduction
Background: During the Zika virus epidemic in Brazil, from January 2015 to December 2018, there were 278,790 people infected, and of these approximately 22,000 women who were pregnant. Consequently, there was a considerable increase in the number of newborns (17,041) with microcephaly and other malformations - Congenital Zika Syndrome (CZS). In our state, in this same period, 427 cases of the disease were confirmed, 185 of which occurred in pregnant women, and there were 16 cases of Congenital Zika Syndrome (CZS).
Objetive
Objective: Clinical folllow up of neuropsychomotor development, and clinical staging and electroencephalographic evolution of the epileptic condition.
Methods
Follow up and clinical evaluation of eleven children suffering from CZS, in which the following were evaluated: head circumference growth, neuropsychomotor development, existence or lack of spasticity, presence or absence of epilepsy and its pharmacological treatment.
Results
The average age of the children was 24 months at the time of the first evaluation and 36 months at the time of the second evaluation. Cerebral palsy has been identified in all children (GMFCS level 5 in 9 cases), microcephaly and pseudobulbar syndrome in eight, and hydrocephalus in three cases. Malnutrition was identified in seven children. Four of the children did not present epilepsy, three evolved to West Syndrome, one had generalized epileptic seizures and three had focal seizures. Four cases of refractory epilepsy are undergoing polytherapy and one is in monotherapy, and two others progressed without seizures and without anticonvulsants.
Conclusion
In the vast majority of cases, CZS evolves to severe Cerebral Palsy and refractory epilepsy.
