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Comment & Response
May 2017

Congenital Zika Virus Infection: Beyond Neonatal Microcephaly—Reply

Author Affiliations
  • 1Instituto de Pesquisa Professor Amorim Neto (IPESQ), Campina Grande, Paraiba, Brazil
  • 2Instituto de Saude Elpidio de Almeida, Campina Grande, Paraiba, Brazil
  • 3Faculdade de Ciencias Medicas de Campina Grande, Campina Grande, Paraiba, Brazil
  • 4Hospital Municipal Pedro I, Campina Grande, Paraiba, Brazil
  • 5Laboratorio de Neuropatologia do Instituto Estadual do Cerebro Paulo Niemeyer, Rio de Janeiro, Brazil
  • 6Departamento de Genetica, Instituto de Biologia, Universidade, Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
JAMA Neurol. 2017;74(5):610-611. doi:10.1001/jamaneurol.2017.0051

In Reply The fact that several babies were born with arthrogryposis after contracting congenital Zika infection was widely reported in the literature1-4 and was the subject of a review by Leyser et al.5 The Letter to the Editor by Leyser and Nascimento in this issue of JAMA Neurology regarding the pathogenesis of the arthrogryposis sheds light on this finding among babies born with Zika virus congenital infection. We agree with Leyser and Nascimento, and have reported the experience of the first 11 infants investigated by our group1 based on their radiological findings and the neuropathological examination of 2 brains. We also believe that motor nerve cell loss in the spinal cord contributes to the occurrence of arthrogryposis. However, only a small segment of the spinal cord was available for examination in 1 case and it could not be properly oriented to evaluate the amount of motor cells. Therefore, although our impression was that there was motor nerve cell loss, we could not confirm that. However, in the comprehensive neuropathological study we performed in 7 additional cases with the analysis of the whole spinal cord, it was evident that the motor nerve cell loss was implicated in the pathogenesis of arthrogryposis.

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