Marquis Valéria Brandão, de Oliveira Melo Adriana, Pradella-Hallinan Márcia, de Vasconcelos Ataíde Gustavo, Carvalho Maria Durce Costa Gomes, de Barros Miranda-Filho Demócrito, de Alencar Ximenes Ricardo Arraes
Research Institute Professor Joaquim Amorim Neto, Federal University of Campina Grande, Paraiba, Brazil.
Professor Joaquim Amorim Neto Research Institute, Federal University of Campina Grande, Paraiba, Brazil.
Pediatr Neurol. 2025 Aug;169:69-73. doi: 10.1016/j.pediatrneurol.2025.04.014. Epub 2025 May 12.
This study investigates the sleep characteristics and electroencephalographic (EEG) activity in 65 children with microcephaly associated with congenital Zika syndrome (CZS) and severe cerebral palsy. The children, born between 2015 and 2017, tested positive for Zika and exhibited neuroimaging findings consistent with CZS. Extended neurological polysomnography was conducted following American Academy of Sleep Medicine guidelines. Sleep was classified into quiet (N), active (R), and indeterminate (I) phases, with frequent epileptiform activity observed. Epileptiform activity was prevalent during wakefulness, N sleep, and R sleep. Seizures occurred in 29.2% of the children during polysomnography. Key sleep waves like sleep spindles, k-complexes, and delta waves were rarely identified. During wakefulness, a continuous EEG trace was seen in 49.2% of the children, whereas burst-suppression (BS) was noted in 47.7%. The absence of posterior dominant rhythm and the presence of sharp slow wave activity were common. In N sleep, most children exhibited BS activity (63.1%) and sharp slow wave activity (95.3%), with 98.5% showing epileptiform activity. There was little difference in EEG traces between wakefulness and N sleep in over half of the children. In R sleep, continuous EEG trace and rapid eye movement were noted in 53.8% and 69.2% of the children, respectively, with 93.8% showing epileptiform activity. The study suggests that brainstem and cortical lesions may explain these findings, highlighting the complex neurological and sleep patterns in children with CZS and the need for further research.
本研究调查了65名患有与先天性寨卡综合征（CZS）相关的小头畸形和严重脑瘫的儿童的睡眠特征和脑电图（EEG）活动。这些儿童出生于2015年至2017年之间，寨卡检测呈阳性，并表现出与CZS一致的神经影像学检查结果。按照美国睡眠医学学会的指南进行了延长的神经多导睡眠图检查。睡眠被分为安静（N）、活跃（R）和不确定（I）阶段，观察到频繁的癫痫样活动。癫痫样活动在清醒、N期睡眠和R期睡眠期间普遍存在。在多导睡眠图检查期间，29.2%的儿童发生了癫痫发作。很少能识别出像睡眠纺锤波、K复合波和δ波这样的关键睡眠波。在清醒期间，49.2%的儿童观察到脑电图连续，而47.7%的儿童观察到爆发抑制（BS）。后头部优势节律缺失和尖慢波活动存在很常见。在N期睡眠中，大多数儿童表现出BS活动（63.1%）和尖慢波活动（95.3%），98.5%的儿童表现出癫痫样活动。超过一半的儿童在清醒和N期睡眠之间的脑电图波形差异不大。在R期睡眠中，分别有53.8%和69.2%的儿童观察到脑电图连续和快速眼动，93.8%的儿童表现出癫痫样活动。该研究表明，脑干和皮质病变可能解释了这些发现，突出了CZS患儿复杂的神经学和睡眠模式以及进一步研究的必要性。
