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Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure

Children with Congenital Zika Syndrome and microcephaly are at high risk for epilepsy; however, the risk is unclear in normocephalic children with prenatal Zika virus (ZIKV) exposure [Exposed Children (EC)]. In this prospective cohort study, we performed epilepsy screening in normocephalic EC alongs...

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Autores principales: Blackmon, Karen, Waechter, Randall, Landon, Barbara, Noël, Trevor, Macpherson, Calum, Donald, Tyhiesia, Cudjoe, Nikita, Evans, Roberta, Burgen, Kemi S., Jayatilake, Piumi, Oyegunle, Vivian, Pedraza, Otto, Abdel Baki, Samah, Thesen, Thomas, Dlugos, Dennis, Chari, Geetha, Patel, Archana A., Grossi-Soyster, Elysse N., Krystosik, Amy R., LaBeaud, A. Desiree
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728266/
https://www.ncbi.nlm.nih.gov/pubmed/33253174
http://dx.doi.org/10.1371/journal.pntd.0008874
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author Blackmon, Karen
Waechter, Randall
Landon, Barbara
Noël, Trevor
Macpherson, Calum
Donald, Tyhiesia
Cudjoe, Nikita
Evans, Roberta
Burgen, Kemi S.
Jayatilake, Piumi
Oyegunle, Vivian
Pedraza, Otto
Abdel Baki, Samah
Thesen, Thomas
Dlugos, Dennis
Chari, Geetha
Patel, Archana A.
Grossi-Soyster, Elysse N.
Krystosik, Amy R.
LaBeaud, A. Desiree
author_facet Blackmon, Karen
Waechter, Randall
Landon, Barbara
Noël, Trevor
Macpherson, Calum
Donald, Tyhiesia
Cudjoe, Nikita
Evans, Roberta
Burgen, Kemi S.
Jayatilake, Piumi
Oyegunle, Vivian
Pedraza, Otto
Abdel Baki, Samah
Thesen, Thomas
Dlugos, Dennis
Chari, Geetha
Patel, Archana A.
Grossi-Soyster, Elysse N.
Krystosik, Amy R.
LaBeaud, A. Desiree
author_sort Blackmon, Karen
collection PubMed
description Children with Congenital Zika Syndrome and microcephaly are at high risk for epilepsy; however, the risk is unclear in normocephalic children with prenatal Zika virus (ZIKV) exposure [Exposed Children (EC)]. In this prospective cohort study, we performed epilepsy screening in normocephalic EC alongside a parallel group of normocephalic unexposed children [Unexposed Children (UC)]. We compared the incidence rate of epilepsy among EC and UC at one year of life to global incidence rates. Pregnant women were recruited from public health centers during the ZIKV outbreak in Grenada, West Indies and assessed for prior ZIKV infection using a plasmonic-gold platform that measures IgG antibodies in serum. Normocephalic children born to mothers with positive ZIKV results during pregnancy were classified as EC and those born to mothers with negative ZIKV results during and after pregnancy were classified as UC. Epilepsy screening procedures included a pediatric epilepsy screening questionnaire and video electroencephalography (vEEG). vEEG was collected using a multi-channel microEEG® system for a minimum of 20 minutes along with video recording of participant behavior time-locked to the EEG. vEEGs were interpreted independently by two pediatric epileptologists, who were blinded to ZIKV status, via telemedicine platform. Positive screening cases were referred to a local pediatrician for an epilepsy diagnostic evaluation. Epilepsy screens were positive in 2/71 EC (IR: 0.028; 95% CI: 0.003–0.098) and 0/71 UC. In both epilepsy-positive cases, questionnaire responses and interictal vEEGs were consistent with focal, rather than generalized, seizures. Both children met criteria for a clinical diagnosis of epilepsy and good seizure control was achieved with carbamazepine. Our results indicate that epilepsy rates are modestly elevated in EC. Given our small sample size, results should be considered preliminary. They support the use of epilepsy screening procedures in larger epidemiological studies of children with congenital ZIKV exposure, even in the absence of microcephaly, and provide guidance for conducting epilepsy surveillance in resource limited settings.
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spelling pubmed-77282662020-12-17 Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure Blackmon, Karen Waechter, Randall Landon, Barbara Noël, Trevor Macpherson, Calum Donald, Tyhiesia Cudjoe, Nikita Evans, Roberta Burgen, Kemi S. Jayatilake, Piumi Oyegunle, Vivian Pedraza, Otto Abdel Baki, Samah Thesen, Thomas Dlugos, Dennis Chari, Geetha Patel, Archana A. Grossi-Soyster, Elysse N. Krystosik, Amy R. LaBeaud, A. Desiree PLoS Negl Trop Dis Research Article Children with Congenital Zika Syndrome and microcephaly are at high risk for epilepsy; however, the risk is unclear in normocephalic children with prenatal Zika virus (ZIKV) exposure [Exposed Children (EC)]. In this prospective cohort study, we performed epilepsy screening in normocephalic EC alongside a parallel group of normocephalic unexposed children [Unexposed Children (UC)]. We compared the incidence rate of epilepsy among EC and UC at one year of life to global incidence rates. Pregnant women were recruited from public health centers during the ZIKV outbreak in Grenada, West Indies and assessed for prior ZIKV infection using a plasmonic-gold platform that measures IgG antibodies in serum. Normocephalic children born to mothers with positive ZIKV results during pregnancy were classified as EC and those born to mothers with negative ZIKV results during and after pregnancy were classified as UC. Epilepsy screening procedures included a pediatric epilepsy screening questionnaire and video electroencephalography (vEEG). vEEG was collected using a multi-channel microEEG® system for a minimum of 20 minutes along with video recording of participant behavior time-locked to the EEG. vEEGs were interpreted independently by two pediatric epileptologists, who were blinded to ZIKV status, via telemedicine platform. Positive screening cases were referred to a local pediatrician for an epilepsy diagnostic evaluation. Epilepsy screens were positive in 2/71 EC (IR: 0.028; 95% CI: 0.003–0.098) and 0/71 UC. In both epilepsy-positive cases, questionnaire responses and interictal vEEGs were consistent with focal, rather than generalized, seizures. Both children met criteria for a clinical diagnosis of epilepsy and good seizure control was achieved with carbamazepine. Our results indicate that epilepsy rates are modestly elevated in EC. Given our small sample size, results should be considered preliminary. They support the use of epilepsy screening procedures in larger epidemiological studies of children with congenital ZIKV exposure, even in the absence of microcephaly, and provide guidance for conducting epilepsy surveillance in resource limited settings. Public Library of Science 2020-11-30 /pmc/articles/PMC7728266/ /pubmed/33253174 http://dx.doi.org/10.1371/journal.pntd.0008874 Text en © 2020 Blackmon et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Blackmon, Karen
Waechter, Randall
Landon, Barbara
Noël, Trevor
Macpherson, Calum
Donald, Tyhiesia
Cudjoe, Nikita
Evans, Roberta
Burgen, Kemi S.
Jayatilake, Piumi
Oyegunle, Vivian
Pedraza, Otto
Abdel Baki, Samah
Thesen, Thomas
Dlugos, Dennis
Chari, Geetha
Patel, Archana A.
Grossi-Soyster, Elysse N.
Krystosik, Amy R.
LaBeaud, A. Desiree
Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure
title Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure
title_full Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure
title_fullStr Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure
title_full_unstemmed Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure
title_short Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure
title_sort epilepsy surveillance in normocephalic children with and without prenatal zika virus exposure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728266/
https://www.ncbi.nlm.nih.gov/pubmed/33253174
http://dx.doi.org/10.1371/journal.pntd.0008874
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