Microcephaly and Zika virus: Neuroradiological aspects, clinical findings and a proposed framework for early evaluation of child development

• Published in: Infant behavior & development Vol. 49; pp. 70 - 82
• Main Authors: Cicuto Ferreira Rocha, Nelci Adriana, de Campos, Ana Carolina, Cicuto Ferreira Rocha, Fellipe, Pereira dos Santos Silva, Fernanda
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2017
• Subjects: Brain - virology; Child; Child Development - physiology; Early development; Female; Humans; Infant; International Classification of Functionality Disability and Health; Microcephaly; Microcephaly - virology; Zika virus; Zika Virus - pathogenicity; Zika Virus Infection - diagnostic imaging; International Classification of Functionality Disability and Health; Infant; Zika virus; Microcephaly; Early development
• ISSN: 0163-6383; 1879-0453; 1934-8800
• DOI: 10.1016/j.infbeh.2017.07.002

•Little is known about functioning in infants with microcephaly caused by Zika virus.•An ICF-based framework to assess infants with microcephaly can help early developmental assessment.•Comprehensive assessment is recommended for early identification and intervention. As the recent outbreak of microcephaly cases caused by Zika virus has been declared a global health emergency, providing assessment guidelines for multidisciplinary teams providing early developmental screening and stimulation to infants with microcephaly is much needed. Thus, the aim of this manuscript is to provide an overview on what is known about neuroradiological aspects and clinical findings in infants with microcephaly caused by Zika virus and to propose a framework for early evaluation of child development. The keywords “Zika virus” and “microcephaly” were searched in PubMed database for articles published from incept to May 2017. These texts were reviewed, and the ones addressing neuroradiological and clinical findings in infants were selected. Recommendations for early assessment were made based on the International Classification of Functionality Disability and Health (ICF) model. The database search yielded 599 publications and 36 were selected. The studies detected microcephaly with diffuse brain malformations and calcifications, ventriculomegaly, optic nerve hypoplasia, macular atrophy, cataracts, impaired visual and hearing function, arthrogryposis, spasticity, hyperreflexia, irritability, tremors, and seizures, but very little is known about early development. Early assessments were described based on the ICF domains (Body Function and Structures, Activities and Participation and Contextual factors). Studies published showed abnormal brain, optic, neurologic and orthopedic findings, but very little is known about other aspects of functioning in infants with microcephaly caused by Zika virus. The biopsychosocial model based on the ICF paradigm provides an adequate framework to describe the condition of the infant with microcephaly receiving rehabilitative efforts to minimize disability. Efforts towards early identification of developmental delays should be taken within the first six months of life.