Predictors of cochleovestibular dysfunction in children with congenital cytomegalovirus infection

Chebib, Emilien; Maudoux, Audrey; Benoît, Charlotte; Bernard, Sophie; Belarbi, Nadia; Parodi, M.; Picone, Olivier; Abbeele, T. Van Den; Vacher, Sylvette R.; Teissier, Natacha

doi:10.1007/s00431-022-04495-8

Cited by 12 publications

(13 citation statements)

References 48 publications

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“…2), suggests that these patients might be least at risk. Interestingly, a recent study by Chebib et al 50 on predicting factors for inner ear function as a whole (auditory and vestibular function considered together) reported similar findings as we did. They found abnormalities in antenatal imaging and first-trimester seroconversion to be predictive for inner ear function.…”

Section: Discussionsupporting

confidence: 91%

Predicting Early Vestibular and Motor Function in Congenital Cytomegalovirus Infection

et al. 2022

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Objectives: Congenital cytomegalovirus (cCMV) can affect vestibular function, which is an important cornerstone for early motor development. This study aims to identify risk factors for early vestibular dysfunction with severe repercussions on the motor outcome.Methods: This prospective cohort study included 169 cCMV-patients with complete vestibular assessment (lateral video Head Impulse Test and cervical Vestibular Evoked Myogenic Potentials) before the age of 18 months (mean 8.9, standard deviation 3.27 months). Motor results using the Alberta Infant Motor Scale were collected in 152 of these patients. Logistic and linear regression models were applied to identify risk factors for the vestibular and motor outcomes, respectively.Results: The odds of developing early vestibular dysfunction were 6 times higher in patients presenting with hearing loss at birth compared to those born with normal hearing (p = .002). Within the latter group, significant predictors for vestibular dysfunction were (delayed-onset) hearing impairment at the time of vestibular testing (p = .003) and the presence of periventricular cysts on magnetic resonance imaging (p = .005). Remarkably, none of the patients infected during the third trimester of pregnancy (n = 14) developed early vestibular dysfunction. On average, vestibular-impaired patients had a z-score on the Alberta Infant Motor Scale that was 1.17 points lower than patients without vestibular deficit (p < .001).Conclusion: Early vestibular loss can have a significant adverse effect on motor development. Hearing and cranial imaging findings could facilitate the widespread implementation of a (targeted) vestibular assessment approach in the cCMV-population.

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Section: Discussionsupporting

confidence: 91%

Predicting Early Vestibular and Motor Function in Congenital Cytomegalovirus Infection

et al. 2022

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“…A previous analysis on a subset of our data identified hearing status, periventricular cysts on magnetic resonance imaging (MRI), and timing of seroconversion as important predictors for early vestibular outcome (Dhondt et al 2022). This is in line with recent findings of Chebib et al (2022a) reporting antenatal imaging results and timing of seroconversion to be predictive of inner-ear function (auditory and vestibular combined). Based on these previous findings and longitudinal data analysis in our large cohort of cCMV-patients, this study aimed to uncover the characteristics and natural course of vestibular function in cCMV to propose an evidence-based vestibular follow-up program with proper balance between its feasibility and sensitivity.…”

Section: Introductionsupporting

confidence: 91%

Vestibular Follow-up Program for Congenital Cytomegalovirus Based on 6 Years of Longitudinal Data Collection

et al. 2023

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Objectives: Congenital cytomegalovirus (cCMV), the leading nongenetic cause of pediatric sensorineural hearing loss, can also affect vestibular function. Literature findings suggest clinical presentation of vestibular loss in cCMV to be as variable as the hearing loss. Still, probably due to the considerable additional burden it entails for both patients and diagnostic centers, longitudinal vestibular follow-up in cCMV is not well-established in clinical practice. Therefore, this study aims to propose an evidence-based vestibular follow-up program with proper balance between its feasibility and sensitivity. Design: In this longitudinal cohort study, 185 cCMV-patients (mean age 3.2 years, SD 1.6 years, range 0.5–6.7 years) were included. Vestibular follow-up data were obtained through lateral video head impulse test (vHIT) and cervical vestibular evoked myogenic potential (cVEMP) evaluations around the ages of 6 months, 1 year, and 2 years. Around 3 and 4.5 years of age, data from vertical vHIT and ocular vestibular evoked myogenic potentials (oVEMP) were also collected. Results: At birth, 55.1% (102/185) of patients were asymptomatic and 44.9% (83/185) were symptomatic. The mean duration of follow-up for all patients was 20.8 (SD 16.3) months (mean number of follow-up assessments: 3.2, SD 1.5). Vestibular loss occurred at some point during follow-up in 16.8% (31/185) of all patients. Six percent (10/164) of patients with normal vestibular function at first assessment developed delayed-onset vestibular loss; 80.0% (8/10) of these within the first 2 years of life. Vestibular deterioration was reported both in patients who had been treated with postnatal antiviral therapy and untreated patients. At final evaluation, both the semicircular and the otolith system were impaired in the majority of vestibular-impaired ears (29/36, 80.6%). Dysfunctions limited to the semicircular system or the otolith system were reported in 4 (4/36, 11.1%) and 3 (3/36, 8.3%) ears, respectively. The occurrence of vestibular loss was highest in patients with first trimester seroconversion (16/59, 27.1%) or with an unknown timing of seroconversion (13/71, 18.3%), patients with sensorineural hearing loss (16/31, 51.6%), and patients with periventricular cysts on magnetic resonance imaging (MRI) (7/11, 63.6%). Conclusions: Longitudinal vestibular follow-up, most intensively during the first 2 years of life, is recommended in cCMV-patients with vestibular risk factors (first trimester or unknown timing of seroconversion; sensorineural hearing loss; periventricular cysts on MRI). If those risk factors can be ruled out, a single evaluation early in life (around 6 months of age) might be sufficient. Both semicircular and otolith system evaluation should be part of the follow-up program, as partial losses were reported.

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“…Note. * When any one of the above remains strictly isolated, the prognosis remains that of an asymptomatic neonate who has a higher risk of developing subsequent partial SNHL [170].…”

Section: Prenatal Signs Of Congenital CMV Infection and Prognosismentioning

confidence: 99%

Primary, Secondary, and Tertiary Prevention of Congenital Cytomegalovirus Infection

Sartori

Egloff

Hcini

et al. 2023

Viruses

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Cytomegalovirus infection is the most common congenital infection, affecting about 1% of births worldwide. Several primary, secondary, and tertiary prevention strategies are already available during the prenatal period to help mitigate the immediate and long-term consequences of this infection. In this review, we aim to present and assess the efficacy of these strategies, including educating pregnant women and women of childbearing age on their knowledge of hygiene measures, development of vaccines, screening for cytomegalovirus infection during pregnancy (systematic versus targeted), prenatal diagnosis and prognostic assessments, and preventive and curative treatments in utero.

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Predictors of cochleovestibular dysfunction in children with congenital cytomegalovirus infection

Cited by 12 publications

References 48 publications

Predicting Early Vestibular and Motor Function in Congenital Cytomegalovirus Infection

Predicting Early Vestibular and Motor Function in Congenital Cytomegalovirus Infection

Vestibular Follow-up Program for Congenital Cytomegalovirus Based on 6 Years of Longitudinal Data Collection

Primary, Secondary, and Tertiary Prevention of Congenital Cytomegalovirus Infection

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