Gouvea Luane A, Martins Marlos, Vivacqua Daniela, Rosseto Julia, Lima Giulia, Frota Ana Cristina, Abreu Thalita, Araujo Alexandra, Hofer Cristina Barroso
28125Universidade Federal do Rio de Janeiro, v. Pedro Calmon, Rio de Janeiro, Brazil.
J Child Neurol. 2021 Jun;36(7):537-544. doi: 10.1177/0883073820983163. Epub 2021 Jan 7.
We aim to describe the long term follow-up of a cohort of children exposed in utero to the Zika virus.
Descriptive study of a cohort of microcephalic children due to Zika virus. Logistic regression was used to evaluate variables associated with worse prognosis epilepsy.
We followed 28 children (15 females), with a median follow-up of 24 months (IQR = 12-28). During the follow-up, 1 infant died. The median head circumference at birth was 29 cm (IQR = 27-31). All presented a global developmental delay. The most frequent central nervous system abnormalities were on cortical development in 22 participants; dysgenesis of corpus callosum in 13; ventriculomegaly in 25; and calcifications in 24. A total of 9 presented ocular abnormalities, 4 auditory impairment. During follow-up, 12 presented with sleep disorders, 10 with irritability, and 23 with epilepsy (2 with generalized tonic-clonic, 3 with generalized tonic-clonic and spasms, 12 with spasms, 3 tonic and spasms, and 3 motor focal and spasms). The median age at the begin of the epilepsy was 4 months (IQR = 2-10), the median number of drugs used to control the epilepsy was 2 (IQR = 2-3). Maternal illicit drug use during pregnancy was associated with worse prognosis epilepsy (Lennox-Gastaut syndrome, West syndrome, or status epilepticus). A total of 19 presented with dysphagia, 10 children required gastrostomy.
Children with microcephaly due to Zika virus presented with several complications during follow-up, as epilepsy, spastic diplegia, and global developmental delay.
我们旨在描述一组子宫内暴露于寨卡病毒的儿童的长期随访情况。
对一组因寨卡病毒导致小头畸形的儿童进行描述性研究。采用逻辑回归评估与癫痫预后较差相关的变量。
我们随访了28名儿童（15名女性），中位随访时间为24个月（四分位间距=12 - 28个月）。随访期间，1名婴儿死亡。出生时中位头围为29厘米（四分位间距=27 - 31厘米）。所有儿童均出现全面发育迟缓。最常见的中枢神经系统异常为22名参与者存在皮质发育异常；13名存在胼胝体发育不全；25名存在脑室扩大；24名存在钙化。共有9名出现眼部异常，4名存在听力障碍。随访期间，12名出现睡眠障碍，10名出现易激惹，23名出现癫痫（2名全身性强直阵挛发作，3名全身性强直阵挛发作合并痉挛，12名痉挛发作，3名强直发作和痉挛发作，3名局灶性运动发作和痉挛发作）。癫痫发作开始的中位年龄为4个月（四分位间距=2 - 10个月），控制癫痫所用药物的中位数量为2种（四分位间距=2 - 3种）。孕期母亲使用违禁药物与癫痫预后较差（Lennox - Gastaut综合征、West综合征或癫痫持续状态）相关。共有19名出现吞咽困难，10名儿童需要胃造口术。
因寨卡病毒导致小头畸形的儿童在随访期间出现了多种并发症，如癫痫、痉挛性双侧瘫和全面发育迟缓。
