title: Sleep EEG patterns in infants with congenital Zika virus syndrome.
abstract: OBJECTIVE
  To describe sleep EEG patterns of neonates, and infants with microcephaly due to congenital Zika virus (ZikV) syndrome.
  
  
  METHODS
  A descriptive case series of EEGs performed in a cohort of neonates with microcephaly monitored from October 2015 to February 2016 at a University Hospital in Northeast Brazil. Infants were investigated following an established protocol that includes EEG, neuroimaging studies, PCR and specific antibodies for ZikV detection.
  
  
  RESULTS
  EEGs (n=37) from 37 infants were reviewed. Age at investigation varied from 1 to 5months (mean=2.6). Diffuse low voltage (n=7), background asymmetry (n=6) and modified hypsarrhythmia with or without burst-suppression (n=11), were the main background abnormalities identified. Interictal EEG abnormalities were identified in 23 recordings (62%) and localized as focal frontal (n=8) or occipital (n=2) spikes/sharp, multifocal spikes/sharp waves (n=13). Electrographic seizures without clinical manifestation were identified in 4 recordings and characterized as focal pseudo rhythmic pattern. Further findings were focal high amplitude slow waves that were registered in the frontal (n=3) or occipital (n=1) regions.
  
  
  CONCLUSIONS
  Different types of EEG abnormalities were encountered with a predominance of interictal epileptogenic activity and hypsarrhythmia.
  
  
  CONCLUSIONS
  Sleep EEGs in congenital Zika virus syndrome are consistently abnormal even in infants who have not yet developed epilepsy.
authors.affiliation: UPE (University of Pernambuco), Recife, Brazil.
authors.forename: Maria Durce Costa Gomes
authors.initials: MDCG
authors.lastname: Carvalho
authors.affiliation: UPE (University of Pernambuco), Recife, Brazil.
authors.forename: Demócrito de Barros
authors.initials: DB
authors.lastname: Miranda-Filho
authors.affiliation: Associação de Assistência à Criança Deficiente (AACD), Recife, Brazil.
authors.forename: Vanessa
authors.initials: V
authors.lastname: van der Linden
authors.affiliation: UPE (University of Pernambuco), Recife, Brazil.
authors.forename: Paula Fabiana
authors.initials: PF
authors.lastname: Sobral
authors.affiliation: UPE (University of Pernambuco), Recife, Brazil.
authors.forename: Regina Coeli Ferreira
authors.initials: RCF
authors.lastname: Ramos
authors.affiliation: UPE (University of Pernambuco), Recife, Brazil.
authors.forename: Maria Ângela Wanderley
authors.initials: MÂW
authors.lastname: Rocha
authors.affiliation: Department of Virology, Aggeu Magalhães Research Center, Fiocruz-PE, Brazil.
authors.forename: Marli Tenório
authors.initials: MT
authors.lastname: Cordeiro
authors.affiliation: UPE (University of Pernambuco), Recife, Brazil.
authors.forename: Sarah Pinheiro
authors.initials: SP
authors.lastname: de Alencar
authors.affiliation: School of Medicine - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) and Brain Institute of Rio Grande do Sul (BraIns), Porto Alegre, Brazil. Electronic address: nunes@pucrs.br.
authors.forename: Magda Lahorgue
authors.initials: ML
authors.lastname: Nunes
mesh_terms: D015331:Cohort Studies; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008831:Microcephaly / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000503:physiopathology*; D000071244:Zika Virus; D000071243:Zika Virus Infection / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*
keywords: EEG; Microcephaly; Newborns; Zika virus