Cicuto Ferreira Rocha Nelci Adriana, de Campos Ana Carolina, Cicuto Ferreira Rocha Fellipe, Pereira Dos Santos Silva Fernanda
Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Carlos, SP, 13565-905, Brazil.
Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Carlos, SP, 13565-905, Brazil.
Infant Behav Dev. 2017 Nov;49:70-82. doi: 10.1016/j.infbeh.2017.07.002. Epub 2017 Jul 26.
As the recent outbreak of microcephaly cases caused by Zika virus has been declared a global health emergency, providing assessment guidelines for multidisciplinary teams providing early developmental screening and stimulation to infants with microcephaly is much needed. Thus, the aim of this manuscript is to provide an overview on what is known about neuroradiological aspects and clinical findings in infants with microcephaly caused by Zika virus and to propose a framework for early evaluation of child development.
The keywords "Zika virus" and "microcephaly" were searched in PubMed database for articles published from incept to May 2017. These texts were reviewed, and the ones addressing neuroradiological and clinical findings in infants were selected. Recommendations for early assessment were made based on the International Classification of Functionality Disability and Health (ICF) model.
The database search yielded 599 publications and 36 were selected. The studies detected microcephaly with diffuse brain malformations and calcifications, ventriculomegaly, optic nerve hypoplasia, macular atrophy, cataracts, impaired visual and hearing function, arthrogryposis, spasticity, hyperreflexia, irritability, tremors, and seizures, but very little is known about early development. Early assessments were described based on the ICF domains (Body Function and Structures, Activities and Participation and Contextual factors).
Studies published showed abnormal brain, optic, neurologic and orthopedic findings, but very little is known about other aspects of functioning in infants with microcephaly caused by Zika virus. The biopsychosocial model based on the ICF paradigm provides an adequate framework to describe the condition of the infant with microcephaly receiving rehabilitative efforts to minimize disability. Efforts towards early identification of developmental delays should be taken within the first six months of life.
鉴于近期寨卡病毒引发的小头畸形病例已被宣布为全球卫生紧急事件，迫切需要为多学科团队提供评估指南，以便对小头畸形婴儿进行早期发育筛查和刺激。因此，本论文的目的是概述寨卡病毒所致小头畸形婴儿的神经放射学特征和临床发现，并提出儿童发育早期评估框架。
在PubMed数据库中检索关键词“寨卡病毒”和“小头畸形”，查找自数据库建立至2017年5月发表的文章。对这些文章进行综述，选取涉及婴儿神经放射学和临床发现的文章。基于国际功能、残疾和健康分类（ICF）模型提出早期评估建议。
数据库检索得到599篇出版物，选取了36篇。研究发现小头畸形伴有弥漫性脑畸形和钙化、脑室扩大、视神经发育不全、黄斑萎缩、白内障、视觉和听觉功能受损、关节挛缩、痉挛、反射亢进、易激惹、震颤和癫痫发作，但对早期发育了解甚少。基于ICF领域（身体功能和结构、活动与参与以及环境因素）描述了早期评估情况。
已发表的研究显示存在脑、视神经、神经和骨科方面的异常发现，但对寨卡病毒所致小头畸形婴儿功能的其他方面了解甚少。基于ICF范式的生物心理社会模型为描述接受康复治疗以尽量减少残疾的小头畸形婴儿状况提供了适当框架。应在婴儿出生后的前六个月内努力尽早识别发育迟缓。
