Colognese Bianca Aparecida, Argollo Nayara
Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Salvador, Bahia, Brazil.
Rev Inst Med Trop Sao Paulo. 2024 Dec 6;66:e66. doi: 10.1590/S1678-9946202466066. eCollection 2024.
The Zika virus (ZIKV) has been associated with several complications, including acute transverse myelitis (ATM), an acute inflammation of the spinal cord, with rapid development of motor, sensory and dysautonomic symptoms. It is a rare disease, and its clinical features, as well as differences in relation to idiopathic ATMs, are still not completely known. The objective of this paper is to review the literature in search of clinical features and complementary exams of ATM post-ZIKV infection, alone or in association with other neurological conditions (mixed diseases), as well as its treatments and prognoses. The search was made on 5 databases, using the PRISMA methodology (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Nine articles were selected (total of 20 subjects), which were divided between isolated ATM and mixed neurological syndromes with ATM. The study found a predominance of individuals aged 20 to 30. Among the six subjects in the mixed group, three were over 50 years old. The median prodromal period was 2 days for the mixed diseases group and 7 days for the isolated ATM group. Some individuals in the isolated ATM group exhibited signs of dysautonomia, such as syncope, postural lability, and arrhythmia. The mixed group had a higher incidence of coinfections, with 4 cases compared to 1 case in the isolated ATM group. Over 50% of the individuals had moderate to moderately severe disability. These findings suggest that severe conditions may progress to significant sequelae, highlighting the need for prompt diagnosis and treatment, particularly during endemic periods.
寨卡病毒（ZIKV）与多种并发症有关，包括急性横贯性脊髓炎（ATM），这是一种脊髓的急性炎症，会迅速出现运动、感觉和自主神经功能障碍症状。它是一种罕见疾病，其临床特征以及与特发性急性横贯性脊髓炎的差异仍不完全清楚。本文的目的是回顾文献，以寻找寨卡病毒感染后急性横贯性脊髓炎的临床特征、辅助检查，单独或与其他神经系统疾病（混合性疾病）相关的情况，以及其治疗方法和预后。使用PRISMA方法（系统评价和Meta分析的首选报告项目）在5个数据库中进行了检索。共筛选出9篇文章（共20名受试者），分为孤立性急性横贯性脊髓炎和伴有急性横贯性脊髓炎的混合性神经综合征。研究发现，20至30岁的个体占多数。在混合组的6名受试者中，有3名年龄超过50岁。混合性疾病组的前驱期中位数为2天，孤立性急性横贯性脊髓炎组为7天。孤立性急性横贯性脊髓炎组的一些个体表现出自主神经功能障碍的迹象，如晕厥、姿势不稳和心律失常。混合组的合并感染发生率更高，有4例，而孤立性急性横贯性脊髓炎组为1例。超过50%的个体有中度至中度严重残疾。这些发现表明，严重情况可能会发展为严重后遗症，凸显了及时诊断和治疗的必要性，特别是在流行期间。
