Neurodevelopment of 24 children born in Brazil with congenital Zika syndrome in 2015: a case series study

OBJECTIVE: To describe the neurodevelopment of children with congenital Zika syndrome during the second year of life. DESIGN: Case series study. SETTING: Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Pernambuco, Brazil. PARTICIPANTS: 24 children with congenital Zika syndrome born with microcephaly during the Zika outbreak in Brazil in 2015 and followed up at the IMIP during their second year of life. MAIN OUTCOME MEASURE: Denver Developmental Screening Test II, head circumference and clinical neurological examination. RESULTS: All children presented neurodevelopmental delay: for an average chronological age of 19.9 months, language was equivalent to that of age 2.1 months, gross motor 2.7 months, fine motor/adaptive 3.1 months and personal/social 3.4 months. Head circumference remained below the third percentile for age and gender, and growth rate up to the second year of life was 10.3 cm (expected growth 13 cm). Muscle tone was increased in 23 (95.5%) of 24 children, musculotendinous reflexes were increased in the whole sample and clonus was present in 18 (77.3%) of 24 children. All children except one had epilepsy. CONCLUSION: Children born with microcephaly associated with congenital Zika virus have a significant neurodevelopmental delay.