Kanda Paulo Afonso Medeiros, Aguiar Aline de Almeida Xavier, Miranda Jose Lucivan, Falcao Alexandre Loverde, Andrade Claudia Suenia, Reis Luigi Neves Dos Santos, Almeida Ellen White R Bacelar, Bello Yanes Brum, Monfredinho Arthur, Kanda Rafael Guimaraes
a Neurovale EEG Laboratory , Taubaté , São Paulo , Brazil.
b Neurophysiology Department , Municipal Government of Teresina , Teresina , Piaui , Brazil.
Neurodiagn J. 2018;58(1):11-29. doi: 10.1080/21646821.2018.1428461.
Microcephaly (MC), previously considered rare, is now a health emergency of international concern because of the devastating Zika virus pandemic outbreak of 2015. The authors describe the electroencephalogram (EEG) findings in sleep EEG of epileptic children who were born with microcephaly in areas of Brazil with active Zika virus transmission between 2014 and 2017. The authors reviewed EEGs from 23 children. Nine were females (39.2%), and the age distribution varied from 4 to 48 months. MC was associated with mother positive serology to toxoplasmosis (toxo), rubella (rub), herpes, and dengue (1 case); toxo (1 case); chikungunya virus (CHIKV) (1 case); syphilis (1 case); and Zika virus (ZIKV) (10 cases). In addition, 1 case was associated with perinatal hypoxia and causes of 9 cases remain unknown. The main background EEG abnormality was diffuse slowing (10 cases), followed by classic (3 cases) and modified (5 cases) hypsarrhythmia. A distinct EEG pattern was seen in ZIKV (5 cases), toxo (2 cases), and undetermined cause (1 case). It was characterized by runs of frontocentrotemporal 4.5-13 Hz activity (7 cases) or diffuse and bilateral runs of 18-24 Hz (1 case). In ZIKV, this rhythmic activity was associated with hypsarrhythmia or slow background. Further studies are necessary to determine if this association is suggestive of ZIKV infection. The authors believe that EEG should be included in the investigation of all newly diagnosed congenital MC, especially those occurring in areas of autochthonous transmission of ZIKV.
小头畸形（MC）以前被认为较为罕见，由于2015年毁灭性的寨卡病毒大流行爆发，现在已成为国际关注的卫生紧急情况。作者描述了2014年至2017年期间巴西寨卡病毒活跃传播地区出生时患有小头畸形的癫痫儿童睡眠脑电图（EEG）的结果。作者回顾了23名儿童的脑电图。其中9名是女性（39.2%），年龄分布在4至48个月之间。小头畸形与母亲弓形虫病（toxo）、风疹（rub）、疱疹和登革热血清学阳性（1例）、弓形虫病（1例）、基孔肯雅病毒（CHIKV）（1例）、梅毒（1例）和寨卡病毒（ZIKV）（10例）有关。此外，1例与围产期缺氧有关，9例病因不明。主要的背景脑电图异常是弥漫性减慢（10例），其次是典型（3例）和改良（5例）高度节律失调。在寨卡病毒（5例）、弓形虫病（2例）和病因不明（1例）中观察到一种独特的脑电图模式。其特征是额中央颞部4.5 - 13赫兹活动的发作（7例）或18 - 24赫兹的弥漫性双侧发作（1例）。在寨卡病毒感染中，这种节律性活动与高度节律失调或缓慢背景有关。需要进一步研究以确定这种关联是否提示寨卡病毒感染。作者认为脑电图应纳入所有新诊断的先天性小头畸形的检查中，特别是那些发生在寨卡病毒本地传播地区的病例。
