Introduction

Recently, a new congenital infection was described in Brazil, the congenital Zika syndrome.  However, as a new disease its evolution is still unknown. The  aim of this study is to report 22 infants with the association of congenital Zika syndrome with infantile spasms.

Methods

This was an observational retrospective study performed from September 2015 to September  2017.

Results

From 109 children with congenital Zika syndrome initially followed, 102 had a complete follow-up during the first year of life. 42.2% developed epilepsy:  21.6 % infantile spasms,  11.8%  generalized and 8.9%  partial.

The median age of infantile spasms onset was 4.3 (± 1.4) months; starting  from 1 to 7 months. Neurologic evaluation showed that all 22 children presented severe impairment of neuropsychomotor development. An interictal hypsarrhythmia electroencephalogram pattern was found in 18 infants.

Discussion

All 22 studied infants had a compatible clinical condition with infantile spasms associated with severe impairment of neuropsychomotor development.

All 22 studied children had severe microcephaly and neuroimaging alterations. This demonstrates  that congenital infection by Zika virus should be added as an etiological agent of infantile spasms.

Neurodevelopmental outcome is overall poor in patients with infantile spasms especially in those with known etiology.

Conclusion

This study emphasizes the increased risk of infantile spasms in children with congenital Zika syndrome and the need for early diagnosis and treatment to prevent further neurologic and developmental impact. Congenital Zika syndrome should  be added as an etiological agent of infantile spasms.