Congenital Zika Virus Infection Induces Severe Spinal Cord Injury

Abstract

We report 2 fatal cases of congenital Zika virus (ZIKV) infection. Brain anomalies, including atrophy of the cerebral cortex and brainstem, and cerebellar aplasia were observed. The spinal cord showed architectural distortion, severe neuronal loss, and microcalcifications. The ZIKV proteins and flavivirus-like particles were detected in cytoplasm of spinal neurons, and spinal cord samples were positive for ZIKV RNA.

Congenital Zika Virus Infection: a Review with Emphasis on the Spectrum of Brain Abnormalities

“…The spectrum of neurological abnormalities in CZS also includes spinal cord injuries. Immunohistochemistry showed immunoreactivity for the ZIKV proteins in the gray matter of the spinal cord [64]. Needle electromyography showed moderate signs of remodeling of the motor units (polyphasic motor unit potentials with increased amplitude and duration) and a reduced recruitment pattern, suggesting chronic involvement of peripheral motor neurons [65].…”

Genetics and mechanisms leading to human cortical malformations

“…ZIKV was found in fetal brain tissue presenting microcephaly with almost complete agyria, hydrocephalus, together with multifocal dystrophic calcifications in the cortex and subcortical white matter [306]. Moreover, ZIKV infection has been reported to induce not only atrophy of the cortex and brainstem, but also cerebellar hypoplasia, macrocephaly, hydranencephaly, brain and spinal cord inflammation, arthrogryposis, ventriculomegaly, pulmonary hypoplasia, and architectural distortion of the spinal cord presenting severe neuronal loss and microcalcifications among others features [307,308].…”

Unilateral Phrenic Nerve Palsy in Infants with Congenital Zika Syndrome

“…These findings were also associated with more severely reduced conus medullaris anterior roots and more frequent periventricular calcifications when compared with infants with CZS without arthrogryposis ( 23 ). Recent postmortem examinations of 2 neonates with CZS and arthrogryposis also established the presence of Zika virus and associated tissue injury in the spinal cord ( 24 ). Taken collectively, these results suggest that infants with CZS and arthrogryposis may represent a more severely affected subgroup reflecting earlier fetal infection and possibly more severe interruption in neuronal migration, cortical organization, or both.…”