The Impact of the Zika Virus on Risks for Seizures and Epilepsy

Zika is linked to microcephaly, a serious birth defect that affects a baby's brain.
Tuesday, April 18, 2017

Pastula DM, Yeargin-Allsopp M, Kobau R. Enhanced Epilepsy Surveillance and Awareness in the Age of Zika. JAMA Neurol. Published online April 17, 2017. Doi:10.1001/jamaneurol.2017.0215.

Description of Article

Since the Zika virus (ZIKV) was first detected, many people have been concerned about long-term effects on exposed babies. The impact on the development of infants exposed to the virus has been a concern for some time now. It is not surprising that along with microcephaly, the outward manifestation of the virus, brain development is adversely affected. As the brain grows, we know the head grows. If the brain is not growing normally, then the head does not enlarge normally resulting in microcephaly.

Problems with brain development have been recognized as a possible cause of seizures/epilepsy for many years. Microcephaly is one of these brain development problems and has been associated with exposure to the Zika virus while the mother is pregnant.

The authors of a new commentary published in JAMA Neurology reviewed what is known about the Zika virus, ways in which the Zika virus infection may affect the development of brain cells, and what has been seen so far.

  • An increasing number of outbreaks of Zika virus infections have been seen in the Americas since 2015. Congential ZIKV infection means that a baby born to a mother who had a Zika virus infection during her pregnancy developed symptoms.
  • Problems found in the babies include microcephaly (abnormally small head), which is associated with abnormal development of the brain.
  • Other serious problems of the brain have been seen in affected babies too.

Description of Findings

The article reviewed two reports of babies affected by Zika virus.

  1. Of 48 infants from Brazil who likely had congential ZIKV infection, 50% had seizures.
  2. A different report of 13 infants in Brazil included infants whose laboratory tests confirmed they had ZIKV infections; 7 infants or 54% were diagnosed with epilepsy.
  3. A number of other neurological problems were found in babies with ZIKV.

What does this mean?

  • Congenital Zika virus infection is known to cause microcephaly and severe brain abnormalities in babies.
  • The information in this article highlights the high risk of seizures and epilepsy in these infants and children, as well as risks for developmental and cognitive delay.
  • Seizures in infants may not be diagnosed in a timely manner or may be mistaken for other problems. A delay in recognizing seizures may lead to delays in treatment. This can lead to poor seizure control and other health problems.

Implications and Call to Action

  • The Epilepsy Foundation stresses that the public must be aware of the potential for seizures and epilepsy in infants and children exposed to congenital Zika virus infection.
  • We support increased surveillance by medical professionals and local public health authorities where active Zika virus transmission is seen.
  • Families, other caregivers, and health professionals must know how to recognize the many different types of seizures, especially subtle symptoms that may occur in infants.
  • When seizures or epilepsy is suspected, an infant or child should be seen by a neurologist or epilepsy specialist as soon as possible.
  • Health care providers should ask all parents of children with a new diagnosis of seizures about potential exposure to the Zika virus.
Authored by: Angel Hernandez MD and Christi Heck MD on 4/2017
Reviewed by: Patricia O. Shafer RN, MN on 4/2017

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