engleski

Neurodevelopmental Outcome of Children with Brain Cortical Malformations Caused by Congenital Cytomegalovirus Infection

OBJECT OF STUDY: Purpose of this study was to determine impact of cytomegalovirus (CMV) on cortical development of children with congenital CMV infection since it is the most common vertically transmitted disease. Congenital CMV infection causes multiorgan affection, but the most severe and permanent sequelae are those affecting central nervous system as a result of direct interference of the virus with neurogenesis. Also we tried to connect the time of acquiring infection to the level of child’s disability. METHOD USE: Nine patients (4 boys, 5 girls) with cortical dysgenesis and congenital CMV infection were followed up in a period from 2000 to 2009.with final neurodevelopmental assessment at the age of 5 months to 15 years respectively. Congenital CMV infection was confirmed by serology tests and/or polymerase chain reaction for CMV DNA in serum and/or urine. All of the patients underwent cranial computed tomography and/or magnetic resonance imaging (CT/MRI). RESULTS OBTAINED: CT/MRI revealed lissencephaly in two of our patients suggest an early onset of infection. The other seven with less severe cortical dysplasia in form of pachy/polymicrogyria were probably infected later. Developmental outcome in all of our children was poor: moderate to severe psychomotor retardation has been diagnosed in all ; five of them developed cerebral palsy (four had bilateral spastic and one dyskinetic) and one was estimated to have minor motor dysfunction. Seven out of nine developed epilepsy, chorioretinitis was found in three and sensorineural deafness in two children. CONCLUSION: All of the patients, except one, were presented by symptomatic infection, though only four of them were recognized at birth. Radiological findings of our study indicate an important impact of CMV infection on neurogenesis thus congenital CMV infection should be considered as one of the reasons for childhood disability more often.

neurodevelopmental outcome; cortical malformations; congenital cytomegalovirus infection

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