Classification of Congenital Zika Syndrome: Muscle Tone, Motor Type, Body Segments Affected, and Gross Motor Function

ABSTRACT

Aim: To identify abnormalities in muscle tone and motor function associated with congenital Zika syndrome (CZS).

Method: A cross-sectional observational study involving 96 children (55 males) with CZS at a mean (SD) age 35.2 ± 2.9 months. Children’s muscle tone was investigated using the pull to sit, scarf sign, shoulder suspension and ventral suspension tests and the modified Ashworth scale (MAS). Motor impairment was determined using the Gross Motor Function Classification System (GMFCS) and body segments most affected with motor impairment.

Results: 58 (60,5%) children tested positive for ≥1 maneuver used to evaluate muscle tone, while 38 (39.5%) tested negative in all the tests. MAS score was >0 for at least one of the appendicular muscles in 91 children (94.8%). In 88 children (91.7%), all four limbs were affected.

Conclusion: Findings suggestive of axial hypotonia and appendicular hypertonia associated with severe motor impairment were prevalent in children with CZS.

KEYWORDS:

• muscle hypertonia
• muscle hypotonia
• muscle tone
• Zika virus

Acknowledgments

The authors are grateful to the Brazilian National Council for Scientific and Technological Development (CNPq) for their financial support (#443372/2016-0, #440619/2016-5) and for the grants awarded to Gama G. The authors are also grateful to the Coordination for the Improvement of Higher Education Personnel (CAPES). The authors would also like to thank the children and their mothers or guardians for having participated in this study.

Declaration Of Interest Statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico [443372/2016-0, 440619/2016-5]; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.