Magda L Nunes1, Nathalia B Esper2, Alexandre R Franco3, Graciane Radaelli4, Ricardo B Soder5, Rodrigo Bomfim6, Felipe Kalil Neto7, Fernando T Gameleira8, Mirna W Portuguez9, Jaderson C da Costa10. 1. School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Laboratory of Clinical Neurophysiology Hospital São Lucas PUCRS, Brazil. Electronic address: mlnunes@pucrs.br. 2. Division of Neuroimage from the Brain Institute (BraIns), Brazil. Electronic address: nathalia.esper@pucrs.br. 3. The Nathan S. Kline Institute for Psychiatric Research, USA; The Child Mind Institute, USA. Electronic address: Alexandre.Franco@NKI.rfmh.org. 4. Division of Neuroimage from the Brain Institute (BraIns), Brazil. Electronic address: graciane.radaelli@pucrs.br. 5. School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Division of Neuroimage from the Brain Institute (BraIns), Brazil. Electronic address: ricardo.soder@pucrs.br. 6. Hospital Memorial Arthur Ramos, Radiology Division (DIRAD), Brazil. Electronic address: rodrigocbomfim@hotmail.com. 7. Division of Clinical Research from the Brain Institute (BraIns), Brazil. Electronic address: felipekalil@yahoo.com.br. 8. Hospital Universitário Prof. Alberto Antunes, Federal University of Alagoas (UFAL), Brazil. Electronic address: fernandotg@uol.com.br. 9. School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Division of Clinical Research from the Brain Institute (BraIns), Brazil. Electronic address: mirna@pucrs.br. 10. School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Division of Clinical Research from the Brain Institute (BraIns), Brazil. Electronic address: jcc@pucrs.br.
Abstract
PURPOSE: To describe epilepsy after congenital Zika virus infection (ZIKV) and its relationship with structural neuroimaging findings. METHODS: This was a cross-sectional study in children (aged 13-42 months) who were born with microcephaly due to ZIKV infection between 2015-2017. Patients underwent a brain imaging scan (magnetic resonance) and a video-EEG study. RESULTS: Among the patients (n = 43), 55.8 % were male, 88.4 % were born at term, mean head circumference at the birth was 29.7 ± 1.8 cm, and 44.8 % were infected in the first trimester of pregnancy. Neuroimaging was moderately abnormal in 30.2 % and severely abnormal in 46.5 % of patients. Early seizures (<6 months of age) were observed in 41.9 %. EEG background was abnormal when asleep or awake in 72.1 % and during sleep in 62.8 %. The interictal epileptogenic activity was recorded on 41/43 of the EEGs and was predominantly multifocal (62.8 %). An ictal EEG was obtained in 22 patients and 31.8 % had more than one seizure type. Sleep EEG (background) patterns, interictal epileptogenic activity (p = 0.046), interictal discharge localization (p = 0.015), type of ictal epileptogenic activity (p = 0.002), and localization of ictal discharge (p = 0.024) were significantly different between neuroimaging groups. The mild neuroimaging group had a higher chance of having more frequently normal sleep EEG patterns, no interictal epileptogenic activity and a further increase in the probability of walking without limitations, and less neurodevelopment delay. CONCLUSION: In patients with congenital Zika virus syndrome, epilepsy tended to be early and refractory. EEG features correlated with degree of neuroimaging abnormalities.
PURPOSE: To describe epilepsy after congenital Zika virus infection (ZIKV) and its relationship with structural neuroimaging findings. METHODS: This was a cross-sectional study in children (aged 13-42 months) who were born with microcephaly due to ZIKVinfection between 2015-2017. Patients underwent a brain imaging scan (magnetic resonance) and a video-EEG study. RESULTS: Among the patients (n = 43), 55.8 % were male, 88.4 % were born at term, mean head circumference at the birth was 29.7 ± 1.8 cm, and 44.8 % were infected in the first trimester of pregnancy. Neuroimaging was moderately abnormal in 30.2 % and severely abnormal in 46.5 % of patients. Early seizures (<6 months of age) were observed in 41.9 %. EEG background was abnormal when asleep or awake in 72.1 % and during sleep in 62.8 %. The interictal epileptogenic activity was recorded on 41/43 of the EEGs and was predominantly multifocal (62.8 %). An ictal EEG was obtained in 22 patients and 31.8 % had more than one seizure type. Sleep EEG (background) patterns, interictal epileptogenic activity (p = 0.046), interictal discharge localization (p = 0.015), type of ictal epileptogenic activity (p = 0.002), and localization of ictal discharge (p = 0.024) were significantly different between neuroimaging groups. The mild neuroimaging group had a higher chance of having more frequently normal sleep EEG patterns, no interictal epileptogenic activity and a further increase in the probability of walking without limitations, and less neurodevelopment delay. CONCLUSION: In patients with congenital Zika virus syndrome, epilepsy tended to be early and refractory. EEG features correlated with degree of neuroimaging abnormalities.
Authors: Lavínia Schuler-Faccini; Miguel Del Campo; Alfredo García-Alix; Liana O Ventura; Juliano André Boquett; Vanessa van der Linden; André Pessoa; Hélio van der Linden Júnior; Camila V Ventura; Mariana Carvalho Leal; Thayne Woycinck Kowalski; Lais Rodrigues Gerzson; Carla Skilhan de Almeida; Lucélia Santi; Walter O Beys-da-Silva; André Quincozes-Santos; Jorge A Guimarães; Patricia P Garcez; Julia do Amaral Gomes; Fernanda Sales Luiz Vianna; André Anjos da Silva; Lucas Rosa Fraga; Maria Teresa Vieira Sanseverino; Alysson R Muotri; Rafael Lopes da Rosa; Alberto Mantovani Abeche; Clairton Marcolongo-Pereira; Diogo O Souza Journal: Front Genet Date: 2022-03-08 Impact factor: 4.599