Achados clínicos de neuroimagem e videoencefalograma e a relação com a funcionalidade de crianças com síndrome congênita pelo vírus Zika

Abstract

Introdution: The congenital infection by Zika virus could result in Central Nervous System (SNC) injures and could occasion neuropsychomotor development disorder (ADNPM), predictive factors to skills acquisition to the daily life activities. Purpose: Apprise the functionality of children with congenital syndrome by Zika virus (SCZ) from clinical standards of neuroimaging and videocefalogram of children accompanied by Sarah Fortaleza Neurorehabilitation Center. Method: Cross-sectional study accomplished between august of 2017 and january of 2019 with 48 confirmed diagnosis SCZ children according to clinical, radiological and laboratory criteria established by Ministry of Health. The clinical data were obtained by the records of the electronic medical records. The children were evaluated in relation to the acquisition of motor and cognitive developmental marks, comorbidities, anthropometric data besides neuroimaging and videocefalogram. For rating of the functionality, was used the inventory PEDI CAT. Results: The signs and symptoms of ZIKV infection at pregnancy were 89,6% in woman in the first quarter of pregnancy, being rash, fever and itching the most relevant ones. The average age of the children was 33 months, being the majority female. All of them attended motor changes that filled the clinical criteria for a cerebral palsy diagnosis, spastic quadriplegia type and marks of development reached corresponded the age of 2 to 4 months. Among the clinical alterations, was obtained higher percentage of epilepsy (93.8%), intestinal bladder incontinence (97.9%), change in swallowing (83.3%), dysmorphism (89%), neurogenic irritability (81.3%), strabismus (75%), change sleep (72.9%), gastroesophageal reflux (62%), visual changes (62.5%). At birth, the majority of the children had proper weight for the gestational age and the most of them showed severe microcephaly and eutrophy. The evaluated children showed severe impairment of neuropsychomotor development. The most frequently findings from neuroimage were corpus callosum abnormality, calcification at corticosubcortical junction, pachygyria-like cortical abnormality, ventriculomegaly, basal nucleus calcification, and moderate and severe cerebral parenchyma volume reduction. A particular aspect is the local of calcification at corticosubcortical junction. This has been recognized as a SCZ typical feature. Only one child was classified as CMFCS II. Rating PEDI CAT with AD-Score T and SC-Score T were revealed significant association with GMFCS (p= <0.001 and 0,033). Most of the rated child adjusted to PEDICAT model (score >-1,65. When rating the association between the PEDI-CAT domains and the development marks, was observed significant association between AD-Score T, MB-Score T and SC-Score T. It became evident the significant association between hip subluxation and SC-Score T, p=0.028 and AD-Score T, p=0.035, both with scores < 30.With not rolling acquisition (motor) and AD-score T (p = 0,026; <30), GMFCS and the MB-Score T (p = 0,022; <30), GMFCS and the SC-Score T (p = 0,033; <30) and GMFCS and the AD-Score T (p< 0,001;< 30),were a significant association. About the corpus callosum abnormality(neuroimaging) and the SC-Score T (p = 0,034;<30) and the AD-Score T (p = 0,018;<30), were obtained significant association. Were association between maturation sign (videoencefalogram) with AD-Score T (p=0,019). Conclusion: Children with SCZ showed frequency in motor, clinical, neuroimaging and videoencafalogram alteration and the predictive for functionality at AD-Score T, MB-Score T and SC-Score T.