The Zika virus can induce a disruptive sequence in the fetal brain and is manifested mainly by microcephaly. Knowledge gaps still exist as to whether the virus can cause minor disorders that are perceived later on during the first years of life in children who are exposed but are asymptomatic at birth. In this case series, we describe the outcomes related to neurodevelopment through the neurological assessment of 26 non-microcephalic children who had intrauterine exposure to Zika virus. Children were submitted for neurological examinations and Bayley Scales-III (cognition, language, and motor performance). The majority (65.4%) obtained satisfactory performance in neurodevelopment. The most impaired domain was language, with 30.7% impairment. Severe neurological disorders occurred in five children (19.2%) and these were spastic hemiparesis, epilepsy associated with congenital macrocephaly (Zika and human immunodeficiency virus), two cases of autism (one exposed to Zika and Toxoplasma gondii) and progressive sensorineural hearing loss (GJB2 mutation). We concluded that non-microcephalic children with intrauterine exposure to Zika virus, in their majority, had achieved satisfactory performance in all neurodevelopmental domains. One third of the cases had some impairment, but the predominant group had mild alterations, with low occurrence of moderate to severe disorders, similar to other studies in Brazil.

中文翻译：

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暴露于寨卡病毒的无先天性小头畸形儿童子宫内的神经系统发现：病例系列研究

寨卡病毒可在胎儿大脑中诱导破坏性序列，主要表现为小头畸形。关于病毒是否会引起轻度疾病的知识差距仍然存在，这些疾病在生命的最初几年中会在后来接触但出生时无症状的儿童中被发现。在这个案例系列中，我们通过对26名在宫内接触寨卡病毒的非小头畸形儿童进行神经学评估来描述与神经发育相关的结果。儿童接受了神经系统检查和Bayley Scales-III（认知，语言和运动表现）。多数（65.4％）的神经发育表现令人满意。受损最严重的领域是语言，有30.7％的障碍。5名儿童（19.2％）发生了严重的神经系统疾病，其中包括痉挛性偏瘫，弓形虫）和进行性感觉神经性听力减退（GJB2突变）。我们得出的结论是，在子宫内暴露于寨卡病毒的非小头畸形儿童中，绝大多数在所有神经发育领域均表现出令人满意的表现。三分之一的病例有一定程度的损伤，但主要的病例有轻度的改变，中度至重度疾病的发生率较低，与巴西的其他研究相似。