Motor and cognitive response to intensive multidisciplinary therapy: the first reported case of congenital Zika virus syndrome

ABSTRACT

Purpose

To provide a detailed description of the development of the first case of congenital Zika syndrome (CZS) to be reported in the literature worldwide.

Case Description

This report describes the case of a child with CZS monitored from pregnancy until four years of age, with periodic evaluations of head circumference, weight, height, motor function according to the Gross Motor Function Measure (GMFM-88), and the occurrence of comorbidities.

Outcomes

The child’s birth weight and length were normal (z-score = 1.1 and −1.95, respectively), while head circumference was below the expected value (z-score = −3.15). At 48 months, head circumference reached 43 cm (z-score = −4.48). During daily home physiotherapy sessions, the child achieved developmental milestones, standing unsupported at 17 months, with a GMFM-88x score of 137. With specialist therapy, the child walked independently at 36 months and a total GMFM-66 score of 214 was achieved by 42 months. In the four years of follow-up, the child was hospitalized four times for different reasons. No convulsive seizures occurred.

Conclusions

Despite severe neurological impairment, the child’s weight and height are adequate for age, with motor and cognitive function improving over the first four years of life.

KEYWORDS:

• Zika virus
• physiotherapy
• motor function
• clinical course
• development

Acknowledgments

This report received support from the Coordination for the Improvement of Higher Education Personnel (CAPES)/Ministry of Education (MEC) (grant no. 443372/2016-0), with additional grants being awarded to J.S. Tavares by the National Council for Scientific and Technological Development (CNPq) (grant no. 440619/2016-5), and to G.L. Gama. This work was also supported by the Department of Science and Technology, Secretariat of Science, Technology and Strategic Supplies, Ministry of Health. In addition, the authors would like to thank the entire research department at Research Institute Professor Joaquim Amorim Neto, as well as the children and their mothers or guardians for having participated.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

MCTIC/FNDCT-CNPq/MEC-CAPES/MS-Decit, Grant/Award Numbers:425136/2016-7, 443372/2016-0, 425136/2016-7 428837/2016-6, 440488/2016-8.