What is Microcefalia(Zika virus) - Causes, Symptoms, and Treatment?

Microcephaly, which has always been a comparatively unusual and poorly understood problem within the general population, has recently gained much notoriety because of its association with Zika infection during pregnancy.

In this article, we will explain what microcephaly is, what are its main causes, its symptoms, the types of diagnosis, and, therefore, the treatment options.

Here, let's speak about microcephaly normally, associated with several distinct diseases, including Zika. If you search for specific information about Zika fever microcephaly, visit the following link: ZIKA FEBRE - Causes, Symptoms, Microcephaly, and Treatment.

 

WHAT IS MICROCEPHALY?

The size of the children's heads is directly associated with the dimensions of the brain. If the baby's brain grows, his skull expands within the same proportion.

Our skull consists of six bones that, at birth, are separated by fontanelles (mollies). This separation allows the skull to expand because the brain grows.

The brain literally pushes the bones of the skull, causing them to expand. This expansion rate is higher within the first few months and gradually decreases over time because the fontanelles close and limit the capacity of skull expansion.

 

If for some reason, the fetus doesn't properly develop the brain inside the uterus, it'll change state with a smaller-sized skull than expected. These cases are called congenital microcephaly.

Microcephaly may also be acquired. A baby may have had normal development within the fetal stage, but the brain may stop growing after birth. Over time, your juvenile body will grow faster than your skull, making your head look smaller than expected. These cases that arise after birth are called acquired microcephaly.

Early closure of the fontanelles, called craniosynostosis, is another possible reason for acquired microcephaly. In this case, the brain doesn't grow because there's a limitation of its physical space.

In most cases, microcephaly is said to be a delay in intellectual development. However, in about 15% of patients, microcephaly is mild, and the child may have a traditional or near-normal intelligence level.

 

As already mentioned, microcephaly itself isn't a disease; it's an indication of disease. When a baby has microcephaly, one must try and identify the cause behind this alteration.

We will speak specifying the causes later.

 

CRITERIA FOR MICROCEPHALY

The definition of microcephaly utilized in the introduction of this text is as simple as possible: a head whose circumference is smaller than the circumference expected for youngsters of identical size and age.

However, in practice, we want a somewhat more detailed definition involving numbers or percentages, so this comparison with the remainder of the population is often made.

Historically, the scientific definition of microcephaly has always been somewhat complex and difficult to know for the lay public.

 

The 2 most typically used settings are:

Occipitofrontal circumference (COF) but 2 standard deviations below the mean or less than the 3rd percentile (mild microcephaly).

Occipitofrontal circumference (COF) but 3 standard deviations below the mean (severe microcephaly).

To use the above criteria, one must understand the concept of normal deviation and have a table with the circumferential occipitofrontal circumference curves for the varied ages, considering the characteristics of the population in question.

 

With the emergence of Zika cases in pregnancies, the incidence of microcephaly increased sharply, and also the diagnosis needed to be simplified, a minimum of for newborns.

To facilitate and increase the detection of cases of microcephaly, the globe Health Organization (WHO) has begun to recommend microcephaly as an easy measurement with a head circumference measuring tape (skull circumference), as shown within the photo opens the article.

Boys with cephalic perimeter but or capable 31.9 cm or girls with cephalic perimeter but or adequate to 31.5 cm are considered microcephalic.

It is important to emphasize that this criterion only applies to newborn and full-term children over 37 weeks of gestation.

This criterion isn't useful for the diagnosis of acquired microcephaly or congenital microcephaly in preterm infants.

 

 

CAUSES OF MICROCEPHALY

Several diseases can cause microcephaly, from genetic problems to drugs or drugs during pregnancy, infections, and trauma.

Below we'll list a number of the possible causes:

Disorders of genetic or chromosomal origin, like subnormality, Poland, Edward, Patau, Rett, X-linked microcephaly, and several others.

Complications during childbirth or pregnancy resulting in a lack of oxygen to the baby's brain (hypoxic encephalopathy).

Craniosynostosis (early fusion of skull bones).

Infections during pregnancy, like rubella, cytomegalovirus, toxoplasmosis, syphilis, varicella, HIV, or Zika.

 

Meningitis.

Use of teratogenic medicines during pregnancy.

Maternal malnutrition.

Consumption of alcohol in pregnancy.

Drug use in pregnancy, like heroin, marijuana, or cocaine.

Smoking during pregnancy.

Radiation exposure.

Maternal folate deficiency.

Maternal metabolic diseases, like phenylketonuria.

 

Maternal poisoning by lead or mercury.

Diabetes mellitus is poorly controlled during pregnancy.

Stroke within the newborn.

Although the above list is large and not complete, many cases of microcephaly find themselves being left unidentified. This usually occurs because they're caused by genetic abnormalities whose research isn't available at their residence, or by inadvertent exposure to harmful substances, or by prenatal infections that weren't diagnosed during pregnancy.

 

SYMPTOMS OF MICROCEPHALY

The signal presents altogether in cases of microcephaly could be a small head of a size disproportionate to the body. Microcephaly capable of causing retardation in intellectual development is usually quite obvious on physical examination.

Some patients with mild microcephaly don't have the other signs or symptoms aside from a head that's but the common of the population. In these cases, called isolated microcephaly or microcephaly vera, intellectual capacities could also be almost or completely preserved.

In most cases, however, microcephaly is among other signs and symptoms, whether or not they stem from poor brain development or from the syndromes themselves that have impeded proper growth of the brain and skull.

 

Depending on the severity of the accompanying syndrome, children with microcephaly may have:

Late intellectual development.

Delay in speech development.

Delay in baby developmental milestones (sit, stand, crawl, walk... )

Motor incoordination.

Muscular rigidity (spasticity).

 

Imbalance.

Facial distortions.

Physical changes are typical of the genetic syndrome of which the patient might be a carrier (such as backwardness, for example).

Short.

Hyperactivity.

Convulsive crisis.

Visual or auditory deficits.

 

DIAGNOSIS OF MICROCEPHALY

 

The diagnosis could also be made even during pregnancy through fetal ultrasound, which is prepared to measure the size of the fetal skull. The foremost effective time for this evaluation is at the tip of the 2nd trimester, during the exam that's usually called "morphological ultrasound."

Even though fetal ultrasonography is normal, the baby's head circumference should be measured 24 hours after birth. If you're normal, your pediatrician should keep measurements during routine appointments until the child is 2 years old and your fontanelles are closed.

If at any time the pediatrician suspects microcephaly, the child should be noted by a specialized pediatrician.

Some imaging tests, like resonance imaging, can provide important information about the baby's brain structure, helping to verify microcephaly and provide recommendations on its possible causes.

 

TREATMENT OF MICROCEPHALY

 

Although there is no cure, there are treatments that help minimize the problems caused by microcephaly.

As already mentioned, infants with mild microcephaly generally present no other problems than a little head. These cases only need monitoring, and no specific treatment is required.

Some surgeries help detach the bones from the skulls for babies with craniosynostosis, allowing the brain to grow without restrictions.

In children with more severe cases, the treatment aims at controlling the associated signs and symptoms, like muscle stiffness, seizures, delayed speech development, etc.

 

The neurological prognosis is directly related to the degree of microcephaly, being worse in patients with occipitofrontal circumference below 3 standard deviations below the mean and those with microcephaly caused by more severe genetic syndromes or infections during pregnancy.