Epilepsy in patients with congenital cytomegalovirus infection

Suzuki, Yasuhiro; Toribe, Yasuhisa; Mogami, Yukiko; Yanagihara, Keiko; Nishikawa, Masanori

doi:10.1016/j.braindev.2007.12.004

Cited by 51 publications

(35 citation statements)

References 9 publications

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“…In contrast with CZS cases, focal seizures are the most common type associated with congenital cytomegalovirus infections. 37,38 As the developmental cortical disorders in the current ZIKV cohort were severe and extensive, this finding may, in part, explain the observed higher incidence and greater severity of epilepsy relative to published reports on congenital cytomegalovirus-associated epilepsy. 37 The role of ZIKV in epileptogenesis is not yet fully understood, but it is well established that congenital infections can lead to structural abnormalities in brain tissue.…”

Section: T a B L E 3 Clinical And Eegmentioning

confidence: 55%

“…37,38 As the developmental cortical disorders in the current ZIKV cohort were severe and extensive, this finding may, in part, explain the observed higher incidence and greater severity of epilepsy relative to published reports on congenital cytomegalovirus-associated epilepsy. 37 The role of ZIKV in epileptogenesis is not yet fully understood, but it is well established that congenital infections can lead to structural abnormalities in brain tissue. We consider that the involvement of the virus in cellular division mechanisms of infected neurons may predispose to changes in cellular electrophysiology, making them hyperexcitable.…”

Section: T a B L E 3 Clinical And Eegmentioning

confidence: 55%

“…Individuals with congenital cytomegalovirus infections appear to present a clinical picture similar to CZS cases, with overlapping clinical and neuroimaging features. The incidence of congenital cytomegalovirus‐associated epilepsy has been reported to vary between 10% and 56%, and the emergence of seizures has been linked to disorders of cortical development, ventriculomegaly, and calcifications. In contrast with CZS cases, focal seizures are the most common type associated with congenital cytomegalovirus infections .…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of congenital cytomegalovirus‐associated epilepsy has been reported to vary between 10% and 56%, and the emergence of seizures has been linked to disorders of cortical development, ventriculomegaly, and calcifications. In contrast with CZS cases, focal seizures are the most common type associated with congenital cytomegalovirus infections . As the developmental cortical disorders in the current ZIKV cohort were severe and extensive, this finding may, in part, explain the observed higher incidence and greater severity of epilepsy relative to published reports on congenital cytomegalovirus‐associated epilepsy …”

Section: Discussionmentioning

confidence: 99%

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Early epilepsy in children with Zika‐related microcephaly in a cohort in Recife, Brazil: Characteristics, electroencephalographic findings, and treatment response

et al. 2020

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Objective To estimate the incidence of epilepsy in children with Zika‐related microcephaly in the first 24 months of life; to characterize the associated clinical and electrographic findings; and to summarize the treatment responses. Methods We followed a cohort of children, born during the 2015‐2016 Zika virus (ZIKV) epidemic in Brazil, with congenital microcephaly and evidence of congenital ZIKV infection on neuroimaging and/or laboratory testing. Neurological assessments were performed at ≤3, 6, 12, 15, 18, 21, and 24 months of life. Serial electroencephalograms were performed over the first 24 months. Results We evaluated 91 children, of whom 48 were female. In this study sample, the cumulative incidence of epilepsy was 71.4% in the first 24 months, and the main type of seizure was infantile spasms (83.1%). The highest incidence of seizures occurred between 3 and 9 months of age, and the risk remained high until 15 months of age. The incidence of infantile spasms peaked between 4 and 7 months and was followed by an increased incidence of focal epilepsy cases after 12 months of age. Neuroimaging results were available for all children, and 100% were abnormal. Cortical abnormalities were identified in 78.4% of the 74 children evaluated by computed tomography and 100% of the 53 children evaluated by magnetic resonance imaging. Overall, only 46.1% of the 65 children with epilepsy responded to treatment. The most commonly used medication was sodium valproate with or without benzodiazepines, levetiracetam, phenobarbital, and vigabatrin. Significance Zika‐related microcephaly was associated with high risk of early epilepsy. Seizures typically began after the third month of life, usually as infantile spasms, with atypical electroencephalographic abnormalities. The seizure control rate was low. The onset of seizures in the second year was less frequent and, when it occurred, presented as focal epilepsy.

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Section: T a B L E 3 Clinical And Eegmentioning

confidence: 55%

Section: T a B L E 3 Clinical And Eegmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Early epilepsy in children with Zika‐related microcephaly in a cohort in Recife, Brazil: Characteristics, electroencephalographic findings, and treatment response

et al. 2020

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“…This mTOR activation phosphorylates p53 at Ser15, and upregulates and translocates Bax into mitochondria (Castedo et al, 2001;Nardacci et al, 2005). D) Epilepsy has been also reported in congenital cytomegalovirus infection cases (Dunin-Wasowicz et al, 2007;Suzuki et al, 2008). Two immediate-early proteins (72KDa IE1 and 86KDa IE2) of human cytomegalovirus (HCMV) can activate AKT by phosphorylating at Thr308 and Ser473 (Yu and Alwine, 2002).…”

Section: Viral Infection In Epilepsy and Mtor Pathwaymentioning

confidence: 99%