Lennox Gastaut Syndrome Sequela of Congenital Zika Virus Infection: A Case Series
Abstract number :
2.414
Submission category :
18. Case Studies
Year :
2023
Submission ID :
357
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Janice Vargas-Rodríguez, MD – University of Puerto Rico, School of Medicine
Janice Rodríguez-Hernández, MD – Child Neurology – University of Puerto Rico, School of Medicine; Mayela Díaz-Díaz, MD – Child Neurology – University of Puerto Rico, School of Medicine; Alexandra Montalvo-Acevedo, MD – Child Neurology – University of Puerto Rico, School of Medicine
Rationale: Congenital Zika virus (ZIKV) infection leads to structural and neuronal migration deficits, resulting in conditions like microcephaly and lissencephaly. Subsequent developmental complications, including epilepsy, may arise. Delayed diagnosis of congenital ZIKV infection hinders timely recognition and treatment of associated epileptic syndromes, which can progress to Lennox Gastaut syndrome (LGS).
Methods: We present a case series of five children diagnosed with congenital ZIKV infection during the neonatal period, with confirmed in utero ZIKV exposure, who later developed LGS. Data was collected on maternal infection gestational age, neonatal tests, neurological examinations, imaging, EEG results, antiseizure medications, epilepsy progression, and other relevant factors. Comparative analysis was performed.
Results: We followed five children with congenital ZIKV infection and confirmed in utero ZIKV exposure who developed LGS. Among them, one child received a late diagnosis, one was lost to follow-up, and one died. Four patients experienced infantile spasms prior to developing LGS. Most patients showed significant improvement on antiseizure polytherapy, as reported by parents. The most common antiseizure medication combination was clobazam and cannabidiol. Previous antiseizure medications included vigabatrin and levetiracetam.
Conclusions: LGS is a severe infantile epileptic syndrome that is highly resistant to antiseizure medications. Common etiologies associated with LGS include abnormal structural development and hypoxic ischemic encephalopathy, among others. However, there is limited literature on the relationship between congenital ZIKV infection and subsequent LGS. Early diagnosis of both congenital ZIKV infection and associated epilepsy can facilitate prompt recognition and treatment of LGS, improving seizure control and quality of life. Recognizing the significance of LGS as a consequence of congenital ZIKV infection may encourage further research and the development of prevention strategies to mitigate the risk of severe epilepsy syndromes like LGS.
Funding: None
Case Studies