Laboratório de Microbiologia Médica, Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu (UFSJ-CCO), Divinópolis, Minas Gerais, Brasil.
Researcher of the Group (CNPq) for Epidemiological, Economic and Pharmacological Studies of Arboviruses (EEPIFARBO), Divinópolis, Brasil.
Epilepsia. 2021 May;62(5):1193-1207. doi: 10.1111/epi.16890. Epub 2021 Mar 29.
To estimate the overall frequency of epilepsy in children with congenital Zika syndrome (CZS) and describe the profile of seizures and the response rate to anti-epileptic treatment in this group of patients.
A systematic review and meta-analysis were conducted following the Cochrane Handbook and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed/MEDLINE, Scopus, Cochrane Library, SciELO, and LILACS were searched until June 23, 2020. Observational studies that evaluated the frequency of epilepsy in children diagnosed with CZS according to international criteria were included in the study.
Fourteen studies evaluating 903 patients diagnosed with CZS were pooled in a meta-analysis. All studies were conducted in Brazil, with reports published between 2016 and 2020, and included children diagnosed with CSZ from 0 to 40 months of age. The overall rate of epilepsy in children diagnosed with CZS was estimated at 60% (95% confidence interval [CI] 0.51-0.68). The studies included in this review show that the frequency of epilepsy in patients with CSZ varies with age, with higher rates in older children. Epileptic spasms was the primary type of seizure observed in this group, followed by focal and generalized crisis. The response rate to anti-epileptic drugs was considerably low, ranging from 20% of seizure control in the first year and 30% in the second year.
Children with CZS presented a high cumulative incidence of epilepsy episodes with increased severity and a low response to anti-epileptic therapy, which is associated with the extensive damage caused by the Zika virus on the cortical structures of patients.
评估先天性寨卡综合征（CZS）患儿癫痫的总体发生率，并描述该组患者癫痫发作的特征和抗癫痫治疗的反应率。
根据 Cochrane 手册和系统评价和荟萃分析的首选报告项目（PRISMA）指南进行系统评价和荟萃分析。检索了 PubMed/MEDLINE、Scopus、Cochrane 图书馆、SciELO 和 LILACS，检索时间截至 2020 年 6 月 23 日。纳入评估根据国际标准诊断为 CZS 的儿童癫痫发生率的观察性研究。
荟萃分析纳入了 14 项评估 903 例 CZS 患儿的研究。所有研究均在巴西进行，报告发表于 2016 年至 2020 年之间，纳入了年龄在 0 至 40 个月的 CSZ 诊断患儿。诊断为 CZS 的儿童癫痫发生率总体估计为 60%（95%置信区间 0.51-0.68）。本综述纳入的研究表明，CSZ 患者癫痫的频率随年龄变化而变化，年龄较大的患儿发生率较高。痉挛性癫痫发作是该组中观察到的主要癫痫发作类型，其次是局灶性和全面性发作。抗癫痫药物的反应率相当低，第一年的癫痫控制率为 20%，第二年为 30%。
CZS 患儿癫痫发作的累积发生率较高，且病情较重，对抗癫痫治疗的反应较低，这与寨卡病毒对患者皮质结构的广泛损害有关。
