engleski

Malformations of Cortical Development in Children with Congenital Cytomegalovirus Infection - A Study of Nine Children with Proven Congenital Cytomegalovirus Infection

: PURPOSE: Congenital cytomegalovirus (CMV) infection is the most common vertically transmitted infection. Occuring early in pregnancy results in severe neurological sequelae, while later infection has less prominent signs. Purpose of study was to determine impact of CMV on cortical development. METHOD: We present nine patients with congenital CMV infection, confirmed by serology tests and/or polymerase chain reaction for CMV DNA in serum and/or urine, and malformations of cortical development and their computed tomography/magnetic resonance (CT/MRI) findings along with clinical assessments. RESULTS: According to CT/MRI results we assume that two of our children with lissencephaly had an early onset of infection. The other seven with less severe cortical dysplasia in form of pachy/polymicrogyria were probably infected later. Results of cerebellar hypoplasia and calcifications also confirm an early onset of infection. Developmental outcome in our children was poor: moderate to severe psychomotor retardation has been diagnosed in all children ; five of them have developed cerebral palsy. Seven of nine developed epilepsy, chorioretinitis was found in three and sensorineural deafness in two children. CONCLUSION: Congenital CMV infection causes multiorgan affection, but the most severe and permanent sequelae are those affecting central nervous system. Radiological findings in our study mostly showed lissencephaly, pachygyria, calcification, cerebellar hypoplasia and/or hypoplasia of corpus callosum that can indicate early and important impact of CMV infection on neurogenesis.

congenital cytomegalovirus infection; cortical malformations; brain development; lissencephaly; pachygyria; polymicrogyria

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