Unilateral Phrenic Nerve Palsy in Infants with Congenital Zika Syndrome

• Main Authors: Nipunie S. Rajapakse, Kevin Ellsworth, Rachael M. Liesman, Mai Lan Ho, Nancy Henry, Elitza S. Theel, Adam Wallace, Ana Catarina Ishigami Alvino, Luisa Medeiros de Mello, Jucille Meneses
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2018-08-01
• Series: Emerging Infectious Diseases
• Subjects: Zika virus; peripheral nervous system; fetal diseases; phrenic nerve; viruses; congenital Zika syndrome
• Online Access: https://wwwnc.cdc.gov/eid/article/24/8/18-0057_article
• ISSN: 1080-6040; 1080-6059

Since the first identification of neonatal microcephaly cases associated with congenital Zika virus infection in Brazil in 2015, a distinctive constellation of clinical features of congenital Zika syndrome has been described. Fetal brain disruption sequence is hypothesized to underlie the devastating effects of the virus on the central nervous system. However, little is known about the effects of congenital Zika virus infection on the peripheral nervous system. We describe a series of 4 cases of right unilateral diaphragmatic paralysis in infants with congenital Zika syndrome suggesting peripheral nervous system involvement and Zika virus as a unique congenital infectious cause of this finding. All the patients described also had arthrogryposis (including talipes equinovarus) and died from complications related to progressive respiratory failure.