The Interplay Between Spasticity and Clinical Variables in Children with Congenital Zika Virus Infection
Jessika M. Mendes1, Nilson N. Mendes Neto2, Marcelo Zacarkim3, Kalyana Fernandes4, Tabata de Alcantara4
1Telemedicos, 2Clinical Investigation, Harvard Medical School, 3Harvard Medical School, 4CRI
Objective:
  • We explored the relationship between spasticity and irritability, intracranial calcification, and seizures in Congenital Zika Syndrome cases.

Background:
Spasticity is a common clinical feature in children with congenital Zika virus (ZIKV) infection, but its relationship with other clinical variables is not well understood.
Design/Methods:

We recruited a cohort of 38 children who were born during the period from January 2015 to May 2016. These children met stringent inclusion criteria that are specifically related to the occurrence of microcephaly resulting from Zika virus (ZIKV) infection. They are under the care and observation at a pediatric rehabilitation center located in the northeastern region of Brazil. Within the framework of this study, we conducted thorough clinical assessments, encompassing a range of standardized evaluations. These assessments involved the quantification of spasticity using established scoring methods, an assessment of irritability, the diagnosis of seizures, and the identification of intracranial calcifications.

Results:

The correlation analysis revealed a moderate positive correlation between spasticity and irritability (r=0.42, p<0.05) and a weak positive correlation with IC (r=0.25, p>0.05). Conversely, there was a weak negative correlation between spasticity and seizures (r=-0.13, p>0.05).


Conclusions:

Spasticity is a well-known cause of chronic pain, which can lead to irritability in children. This may explain the positive association between spasticity and irritability in our study. Our findings highlight the importance of considering the interplay of all neurological symptoms when treating children with congenital Zika syndrome. Our study may offer insights for better clinical understanding and potential interventions in this neglected neurological disease. It also highlights the importance of conducting comprehensive research in neglected neurological conditions to benefit affected children and inform public health efforts.

10.1212/WNL.0000000000206356