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Neurological assessments were performed at \u22643, 6, 12, 15, 18, 21, and 24\u00a0months of life. Serial electroencephalograms were performed over the first 24\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We evaluated 91 children, of whom 48 were female. In this study sample, the cumulative incidence of epilepsy was 71.4% in the first 24\u00a0months, and the main type of seizure was infantile spasms (83.1%). The highest incidence of seizures occurred between 3 and 9\u00a0months of age, and the risk remained high until 15\u00a0months of age. The incidence of infantile spasms peaked between 4 and 7\u00a0months and was followed by an increased incidence of focal epilepsy cases after 12\u00a0months of age. Neuroimaging results were available for all children, and 100% were abnormal. Cortical abnormalities were identified in 78.4% of the 74 children evaluated by computed tomography and 100% of the 53 children evaluated by magnetic resonance imaging. Overall, only 46.1% of the 65 children with epilepsy responded to treatment. The most commonly used medication was sodium valproate with or without benzodiazepines, levetiracetam, phenobarbital, and vigabatrin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Zika\u2010related microcephaly was associated with high risk of early epilepsy. Seizures typically began after the third month of life, usually as infantile spasms, with atypical electroencephalographic abnormalities. The seizure control rate was low. The onset of seizures in the second year was less frequent and, when it occurred, presented as focal epilepsy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16444","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T14:25:40Z","timestamp":1581949540000},"page":"509-518","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Early epilepsy in children with Zika\u2010related microcephaly in a cohort in Recife, Brazil: Characteristics, electroencephalographic findings, and treatment response"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2404-8952","authenticated-orcid":false,"given":"Maria Durce C. G.","family":"Carvalho","sequence":"first","affiliation":[{"name":"University of Pernambuco Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo A. 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A.","family":"Andrade\u2010Valen\u00e7a","sequence":"additional","affiliation":[{"name":"University of Pernambuco Recife Brazil"},{"name":"Federal University of Pernambuco Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie H.","family":"Eickmann","sequence":"additional","affiliation":[{"name":"Federal University of Pernambuco Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina C.","family":"Ramos","sequence":"additional","affiliation":[{"name":"University of Pernambuco Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria \u00c2ngela W.","family":"Rocha","sequence":"additional","affiliation":[{"name":"University of Pernambuco Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thalia V. B.","family":"de Araujo","sequence":"additional","affiliation":[{"name":"Federal University of Pernambuco Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria de F\u00e1tima P. M.","family":"de Albuquerque","sequence":"additional","affiliation":[{"name":"Aggeu Magalh\u00e3es Research Center Fiocruz Pernambuco Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celina M. 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