Abstracts

Rationale: Zika virus is a mosquito-borne neurotropic virus.  Maternal infection can cause fetal brain injury through transplacental transmission.  The Zika virus infects neuronal progenitor cells leading to disrupted neuronal proliferation, migration, and differentiation which can cause microcephaly and other congenital brain malformations with in utero exposure.  Thus we hypothesized that many infants with prenatal Zika exposure would have abnormal MRI and EEG findings which may be correlated in severity. Methods: We performed a retrospective chart review of infants presented to Texas Children’s Hospital (Houston, TX) who underwent an EEG with an ICD-10 diagnostic code for Zika virus.  We reviewed the history for maternal and fetal exposure to Zika virus including viral antibody titers and PCR, brain MRI, and EEG for each patient. Results: One patient with Zika IgM antibody titer confirmation of in utero exposure has severe microcephaly, global developmental delay, and seizures.  Brain MRI showed severe microcephaly, simplified gyral pattern, delayed myelination, and gray matter heterotopias.  An EEG performed at 10 months showed no occipital dominant rhythm, a slow background, and rare left temporal spikes. Another patient with prenatal exposure to Zika confirmed by maternal Zika antibody testing also has severe microcephaly, global developmental delays, and frequent seizures.  Brain MRI showed substantial reduction in cerebral white matter, gray matter heterotopias, a diencephalic mesencephalic junction anomaly, and small dysmorphic basal ganglia.  An EEG at 4 months old showed a disorganized background with shifting frequencies and multifocal epileptiform discharges predominantly over the left hemisphere.  Review of additional patients is ongoing. Conclusions: In utero exposure to Zika virus results in severe microcephaly, congenital brain malformations, global developmental delay, and a high risk for seizures.  Brain MRI and EEGs of these infants are often abnormal with some correlation in severity. Funding: n/a