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Título

CLINICAL AND NEUROPHYSIOLOGICAL EVALUATION OF EPILEPSY IN PATIENTS WITH CONGENITAL ZIKA SYNDROME.

Resumo

INTRODUCTION: Congenital Zika virus syndrome (CZVS) is a pattern of congenital anomalies associated with ZIKV infection during pregnancy. The expanded spectrum of this anomaly includes neurological and non-neurological malformations, with epilepsy being of great prominence. There is wide variation in descriptions of epilepsy, between 9-88.3% of patients. The hypothesis of this investigation is that CZVS courses with epilepsy, at a higher frequency than previously documented, with alterations possibly documented through a 12-hour video electroencephalogram (VEEG) study.
OBJECTIVES: The aim of this study is to describe the characteristics of epilepsy in SCZV, through clinical and electrographic evaluation.
METHODOLOGY: The evaluation was performed using a 12-hour video electroencephalogram, at the Hospital Universitário Walter Cantídio, and the characteristics of epilepsy were evaluated using a questionnaire. This is a non-randomized, cross-sectional study with consecutive inclusion, and the inclusion criteria were: confirmed SCZV and follow-up at the Hospital Infantil Albert Sabin.
RESULTS: Twelve patients with CZVS were evaluated, with a mean age of 4.94 years, eight males, all grade V (transported in a manual wheelchair) in the gross motor function classification (GMFCS) and eleven (91.6%) , with microcephaly at birth. All patients in the sample had epilepsy, with a mean age of onset of epileptic seizures of 12.4 months. The most commonly observed seizures were: focal seizures (91.6%), followed by generalized tonic seizures, in 66.6% and gelastic seizures, in 25% of the sample. Three patients had, between two years and four years, reflex crises when positioned in the supine position. Polytherapy was used in 75% and monotherapy in 16.6%. As for the electroencephalographic characteristics, all patients had disorganized background activity. Interictal epileptiform paroxysms were present in 91.6%, of which 66.67% were activated by sleep. It was detected in 66.67% of electrographic seizures and in 41.67% of electrical sleep disorders.
CONCLUSION: The frequency of epilepsy in the population of children with confirmed CZVS is very high (100% of patients), with varied and often refractory semiology, including subclinical and sleep-activated, being important longer and periodic electrographic evaluation.

Palavras Chave

Congenital Zika virus syndrome; epilepsy