Classification of Congenital Zika Syndrome: Muscle Tone, Motor Type, Body Segments Affected, and Gross Motor Function

Dev Neurorehabil. 2021 Jul;24(5):296-302. doi: 10.1080/17518423.2020.1866706. Epub 2021 Jan 3.


Aim: To identify abnormalities in muscle tone and motor function associated with congenital Zika syndrome (CZS).Method: A cross-sectional observational study involving 96 children (55 males) with CZS at a mean (SD) age 35.2 ± 2.9 months. Children's muscle tone was investigated using the pull to sit, scarf sign, shoulder suspension and ventral suspension tests and the modified Ashworth scale (MAS). Motor impairment was determined using the Gross Motor Function Classification System (GMFCS) and body segments most affected with motor impairment.Results: 58 (60,5%) children tested positive for ≥1 maneuver used to evaluate muscle tone, while 38 (39.5%) tested negative in all the tests. MAS score was >0 for at least one of the appendicular muscles in 91 children (94.8%). In 88 children (91.7%), all four limbs were affected.Conclusion: Findings suggestive of axial hypotonia and appendicular hypertonia associated with severe motor impairment were prevalent in children with CZS.

Keywords: Zika virus; muscle hypertonia; muscle hypotonia; muscle tone.

Publication types

  • Observational Study

MeSH terms

  • Child, Preschool
  • Cross-Sectional Studies
  • Extremities / physiopathology
  • Female
  • Humans
  • Male
  • Muscle Hypertonia / diagnosis
  • Muscle Hypertonia / physiopathology*
  • Muscle Hypotonia / diagnosis
  • Muscle Hypotonia / physiopathology*
  • Muscle Tonus
  • Quadriplegia / physiopathology*
  • Severity of Illness Index
  • Torso / physiopathology
  • Zika Virus
  • Zika Virus Infection / classification
  • Zika Virus Infection / congenital
  • Zika Virus Infection / physiopathology*