Neurological manifestations in children with congenital Zika

*Correspondence: [e-mail].

Abstract

Background: Zika is an arbovirus that emerged in Uganda in 1947. In 2015-2016, the World Health Organization declared the explosion in ZIKV infection associated with microcephaly in South America as a Public Health Emergency of International Concern. The congenital epidemic was due to the virus teratogenicity and tropism for fetal neural tissue that harms the developing brain causing different central nervous system lesions.

Objective: Analyze reported neurological manifestations in children with congenital Zika.

Methods: This study is a literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA methodological recommendations. The databases used were Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature (Lilacs) and PubMed. The search descriptors, used with the Boolean operator AND in all databases, were "congenital”, “Zika virus" and "neurology". Inclusion criteria consisted of original articles, systematic and literature reviews, meta-analyses, randomized clinical trials, published between 2015 and 2023 in English and Portuguese, covering the pediatric population and meeting the study objective. Exclusion criteria included book chapters, case reports, duplicate abstracts, and studies that involved only the adult population.

Results: 28 articles were found, and 13 were selected after screening. The potential neurological malformations caused by Congenital Zika Syndrome (CZS), such as microcephaly and brain calcifications, imply clinical manifestations. During the first year of life, the pyramidal signs are dominant: among 83 infants, hypertonia had the prevalence of 75%, spasticity 17% and hyperreflexia 21%. In the second year, extrapyramidal manifestations, such as dystonic and dyskinetic movements, stand out, with a prevalence of 95.2% in 32 patients. Dysphagia (14.6% of 48 cases) and ocular findings (44.3% of 244 infants) were also present. Higher neurological function deficits are reflected by irritability (85% of 48 infants), minimal contact with the environment and abnormally weak responses to stimuli. Epilepsy was detected in 67% of 141 cases. Hypotonia and weakness were also documented.

Conclusion: The CZS showed a high potential to lead to neurological disorders, whose severe clinical manifestations compromise the adequate development of neurological abilities and the infant’s wellbeing

 

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Publication History

Article published online:
12 May 2025