Focal epilepsy features in a child with Congenital Zika Syndrome

Piumi Jayatilake, Vivian Oyegunle, Randall Waechter, Barbara Landon, Michelle Fernandes, Nikita Cudjoe, Roberta Evans, Trevor Noël, Calum Macpherson, Tyhiesia Donald, Samah G. Abdelbaki, Kesava Mandalaneni, Dennis Dlugos, Geetha Chari, Archana A. Patel, Elysse N. Grossi-Soyster, A. Desiree LaBeaud, Karen Blackmon

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Zika virus (ZIKV) is a mosquito-borne, single-stranded DNA flavivirus that is teratogenic and neurotropic. Similar to the teratogenic effects of other TORCH infections, ZIKV infection during pregnancy can have an adverse impact on fetal and neonatal development. Epilepsy is detected in 48–96% of children with Congenital Zika Syndrome (CZS) and microcephaly. Early epilepsy surveillance is needed in children with prenatal ZIKV exposure; yet, most ZIKV-endemic regions do not have specialist epilepsy care. Here, we describe the demographic, clinical, imaging, and EEG characteristics of a 2-year-old child with CZS and microcephaly who presented with focal epileptiform activity, suboptimal growth, and severe neurodevelopmental delays. Administration of a brief seizure questionnaire by allied health professionals to the patient's caregiver helped to characterize the child's seizure semiology and differentiate focal from generalized seizure features. A telemedicine EEG interpretation platform provided valuable diagnostic information for the patient's local pediatrician to integrate into her treatment plan. This case illustrates that CZS can present with focal epilepsy features and that a telemedicine approach can be used to bridge the gap between epilepsy specialists and local care providers in resource limited ZIKV-endemic regions to achieve better seizure control in children with CZS.

Original languageEnglish
Article number100411
JournalEpilepsy and Behavior Reports
Volume14
DOIs
Publication statusPublished - Jan 2020
Externally publishedYes

Keywords

  • Congenital Zika Syndrome (CZS)
  • Electroencephalography (EEG)
  • Focal Epilepsy
  • Microcephaly
  • Telemedicine

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