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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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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. |
format | Online Article Text |
id | pubmed-7728266 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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