{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T02:43:30Z","timestamp":1767926610420,"version":"3.49.0"},"reference-count":59,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior, Brasil (CAPES)","award":["Financial Code 001"],"award-info":[{"award-number":["Financial Code 001"]}]},{"DOI":"10.13039\/501100016182","name":"Universidade Federal de Mato Grosso do Sul","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100016182","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Clinical outcomes related to congenital Zika syndrome (CZS) include microcephaly accompanied by specific brain injuries. Among several CZS outcomes that have been described, epilepsy and motor impairments are present in most cases. Pharmacological treatment for seizures resulting from epilepsy is performed with anticonvulsant drugs, which in the long term are related to impairments in the child\u2019s neuropsychomotor development. Here, we describe the results from a two-year follow-up of a cohort of children diagnosed with CZS related to the growth of the head circumference and some neurological and motor outcomes, including the pharmacological approach, and its results in the treatment of epileptic seizures. This paper is part of a prospective cohort study carried out in the state of Mato Grosso Sul, Brazil, based on a Zika virus (ZIKV)-exposed child population. Our data were focused on the assessment of head circumference growth and some neurological and motor findings, including the description of seizure conditions and pharmacological management in two periods. Among the 11 children evaluated, 8 had severe microcephaly associated with motor impairment and\/or epilepsy. Seven children were diagnosed with epilepsy. Of these, 3 had West syndrome. In four children with other forms of epilepsy, there was no pharmacological control.<\/jats:p>","DOI":"10.3390\/v12101083","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T22:24:42Z","timestamp":1601245482000},"page":"1083","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Neurological Development, Epilepsy, and the Pharmacotherapy Approach in Children with Congenital Zika Syndrome: Results from a Two-Year Follow-up Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Maria Eulina","family":"Quili\u00e3o","sequence":"first","affiliation":[{"name":"Centro Especializado em Reabilita\u00e7\u00e3o, Associa\u00e7\u00e3o de Pais e Amigos dos Excepcionais, Campo Grande 79050-140, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7458-7057","authenticated-orcid":false,"given":"Fabio Antonio","family":"Venancio","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Doen\u00e7as Infecciosas e Parasit\u00e1rias, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisany Krug","family":"Mareto","sequence":"additional","affiliation":[{"name":"Instituto Integrado de Sa\u00fade, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahra de Almeida","family":"Metzker","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Isabel do","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias Farmac\u00eauticas, Alimentos e Nutri\u00e7\u00e3o, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4021-4639","authenticated-orcid":false,"given":"Daniele Cristina","family":"Vitorelli-Venancio","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Doen\u00e7as Infecciosas e Parasit\u00e1rias, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5478-4977","authenticated-orcid":false,"given":"Cl\u00e1udia Du Bocage","family":"Santos-Pinto","sequence":"additional","affiliation":[{"name":"Instituto Integrado de Sa\u00fade, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-5278","authenticated-orcid":false,"given":"Everton Falc\u00e3o","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Doen\u00e7as Infecciosas e Parasit\u00e1rias, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"},{"name":"Instituto Integrado de Sa\u00fade, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1056\/NEJMcibr1605445","article-title":"Modeling Zika virus infection in pregnancy","volume":"375","author":"Mysorekar","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-019-11866-7","article-title":"Zika virus replicates in adult human brain tissue and impairs synapses and memory in mice","volume":"10","author":"Figueiredo","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_3","unstructured":"Pan American Health Organization, World Health Organization (2018, May 15). Zika Suspected and Confirmed Cases Reported by Countries and Territories in the Americas Cumulative Cases, 2015\u20132017. Available online: https:\/\/www.paho.org\/hq\/index.php?option=com_content&view=article&id=12390:zika-cumulative-cases&Itemid=42090&lang=en."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.paed.2018.10.010","article-title":"An update on Zika Virus and Congenital Zika Syndrome","volume":"29","author":"Oeser","year":"2019","journal-title":"J. Paediatr. Child. Health"},{"key":"ref_5","unstructured":"Brasil Minist\u00e9rio da Sa\u00fade (2020, June 15). Monitoramento dos Casos de Dengue, Febre de Chikungunya e Doen\u00e7a Aguda pelo V\u00edrus Zika at\u00e9 a Semana Epidemiol\u00f3gica 21 de 2020, Available online: https:\/\/www.saude.gov.br\/images\/pdf\/2020\/May\/29\/Boletim-epidemiologico-SVS-22.pdf."},{"key":"ref_6","unstructured":"Centers for Disease Control and Prevention (CDC) (2018, August 25). CDC Concludes Zika Causes Microcephaly and Other Birth Defects, Available online: https:\/\/www.cdc.gov\/media\/releases\/2016\/s0413-zika-microcephaly.html."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.15585\/mmwr.mm6641a1","article-title":"Update: Interim guidance for the diagnosis, evaluation, and management of infants with possible congenital Zika virus infection\u2013United States, October 2017","volume":"66","author":"Adebanjo","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.stem.2016.02.016","article-title":"Zika virus infects human cortical neural progenitors and attenuates their growth","volume":"18","author":"Tang","year":"2016","journal-title":"Cell Stem Cell"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1038\/nature18296","article-title":"The Brazilian Zika virus strain causes birth defects in experimental models","volume":"534","author":"Cugola","year":"2016","journal-title":"Nature"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.cell.2018.03.019","article-title":"Fetal neuropathology in Zika virus-infected pregnant female rhesus monkeys","volume":"173","author":"Martinot","year":"2018","journal-title":"Cell"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1212\/WNL.0000000000002814","article-title":"Cranial bone collapse in microcephalic infants prenatally exposed to Zika virus infection","volume":"87","author":"Horovitz","year":"2016","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Moore, C.A., Staples, J.E., Dobyns, W.B., Pessoa, A., Ventura, C.V., da Fonseca, E.B., Ribeiro, E.M., Ventura, L.O., Nogueira Neto, N., and Arena, J.F. (2017). Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clinicians. JAMA Pediatr., 288\u2013295.","DOI":"10.1001\/jamapediatrics.2016.3982"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/S0140-6736(16)00006-4","article-title":"Zika virus in Brazil and macular atrophy in a child with microcephaly","volume":"387","author":"Ventura","year":"2016","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/S1473-3099(16)00095-5","article-title":"Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: A case study","volume":"16","author":"Calvet","year":"2016","journal-title":"Lancet. Infect. Dis."},{"key":"ref_15","first-page":"i3899","article-title":"Congenital Zika syndrome with arthrogryposis: Retrospective case series study","volume":"354","author":"Filho","year":"2016","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1056\/NEJMoa1600651","article-title":"Zika virus associated with microcephaly","volume":"374","author":"Mlakar","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.3201\/eid2211.160956","article-title":"Early growth and neurologic outcomes of infants with probable congenital Zika virus syndrome","volume":"22","author":"Ganz","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1056\/NEJMoa1602412","article-title":"Zika virus infection in pregnant women in Rio de Janeiro","volume":"24","author":"Brasil","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"30181","DOI":"10.2807\/1560-7917.ES.2016.21.13.30181","article-title":"Congenital cerebral malformations and dysfunction in fetuses and newborns following the 2013 to 2014 Zika virus epidemic in French Polynesia","volume":"21","author":"Besnard","year":"2016","journal-title":"Euro. Surveill."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Venancio, F.A., Bernal, M.E.Q., Ramos, M.D.C.B.V., Chaves, N.R., Hendges, M.V., Souza, M.M.R., de Medeiros, M.J., Pinto, C.B.S., and de Oliveira, E.F. (2019). Congenital Zika Syndrome in a Brazil-Paraguay-Bolivia border region: Clinical features of cases diagnosed between 2015 and 2018. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0223408"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.3174\/ajnr.A5216","article-title":"Nonmicrocephalic Infants with Congenital Zika Syndrome Suspected Only after Neuroimaging Evaluation Compared with Those with Microcephaly at Birth and Postnatally: How Large Is the Zika Virus \u201cIceberg\u201d?","volume":"38","author":"Aragao","year":"2017","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1038\/s41591-019-0496-1","article-title":"Delayed childhood neurodevelopment and neurosensory alterations in the second year of life in a prospective cohort of ZIKV-exposed children","volume":"25","author":"Brasil","year":"2019","journal-title":"Nat. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"59","DOI":"10.15585\/mmwr.mm6503e2","article-title":"Possible association between Zika virus infection and microcephaly - Brazil, 2015","volume":"65","author":"Ribeiro","year":"2016","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S167","DOI":"10.1542\/peds.2017-2038F","article-title":"Motor abnormalities and epilepsy in infants and children with evidence of congenital Zika virus infection","volume":"141","author":"Pessoa","year":"2018","journal-title":"Pediatrics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e021304","DOI":"10.1136\/bmjopen-2017-021304","article-title":"Neurodevelopment of 24 children born in Brazil with congenital Zika syndrome in 2015: A case series study","volume":"8","author":"Alves","year":"2018","journal-title":"BMJ Open"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1056\/NEJMc1716070","article-title":"Epilepsy Profile in Infants with Congenital Zika Virus Infection","volume":"379","author":"Carvalho","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1177\/0883073818780105","article-title":"Congenital Zika Syndrome and Infantile Spasms: Case Series Study","volume":"33","author":"Alves","year":"2018","journal-title":"J. Child. Neurol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/dmcn.14227","article-title":"Motor function in children with congenital Zika syndrome","volume":"62","author":"Melo","year":"2020","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1542\/peds.2012-3998","article-title":"Mortality risks in new-onset childhood epilepsy","volume":"132","author":"Berg","year":"2013","journal-title":"Pediatrics"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Souza, I.N., Barros-Arag\u00e3o, F.G., Frost, P.S., Figueiredo, C.P., and Clarke, J.R. (2019). Late neurological consequences of Zika virus infection: Risk factors and pharmaceutical approaches. Pharmaceuticals, 12.","DOI":"10.3390\/ph12020060"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"World Health Organization (WHO) (2006). Multicentre Growth Reference Study Group. Child Growth Standards based on length\/height, weight and age. Acta. Paediatr. Suppl., 450, 76\u201385.","DOI":"10.1111\/j.1651-2227.2006.tb02378.x"},{"key":"ref_32","unstructured":"Brasil Minist\u00e9rio da Sa\u00fade (2018, May 20). Diretrizes de Estimula\u00e7\u00e3o Precoce: Crian\u00e7as de Zero a 3 Anos Com Atraso no Desenvolvimento Neuropsicomotor, Available online: http:\/\/portalarquivos2.saude.gov.br\/images\/pdf\/2016\/janeiro\/13\/Diretrizes-de-EstimulacaoPrecoce.pdf."},{"key":"ref_33","first-page":"8","article-title":"A report: The definition and classification of cerebral palsy April 2006","volume":"109","author":"Rosenbaum","year":"2007","journal-title":"Dev. Med. Child. Neurol Suppl."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/epi.13670","article-title":"Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology","volume":"58","author":"Fisher","year":"2017","journal-title":"Epilepsia"},{"key":"ref_35","unstructured":"Palisano, R., Rosenbaum, P., Bartlett, D., and Livingston, M. (2007). GMFCS\u2013E & R Gross Motor Function Classification System Expanded and Revised, Canchild Centre for Childhood Disability Research."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"i657","DOI":"10.1136\/bmj.i657","article-title":"Zika virus is a global public health emergency, declares WHO","volume":"352","author":"Gulland","year":"2016","journal-title":"BMJ"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1542\/peds.53.1.2","article-title":"The later growth of the brain and its vulnerability","volume":"53","author":"Dobbing","year":"1974","journal-title":"Pediatrics"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-020-16320-7","article-title":"Long-term alterations in brain and behavior after postnatal Zika virus infection in infant macaques","volume":"11","author":"Raper","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"405","DOI":"10.3201\/eid2303.161499","article-title":"Zika virus RNA replication and persistence in brain and placental tissue","volume":"23","author":"Bhatnagar","year":"2017","journal-title":"Emerg. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-018-3313-4","article-title":"Persistent detection of Zika virus RNA from an infant with severe microcephaly\u2014A case report","volume":"18","author":"Brito","year":"2018","journal-title":"BMC Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1055\/s-2002-36735","article-title":"Relationship between head circumference and brain volume in healthy normal toddlers, children, and adults","volume":"33","author":"Bartholomeusz","year":"2002","journal-title":"Neuropediatrics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1093\/brain\/awh034","article-title":"Critical periods of brain growth and cognitive function in children","volume":"127","author":"Gale","year":"2004","journal-title":"Brain"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1542\/peds.2005-2629","article-title":"The influence of head growth in fetal life, infancy, and childhood on intelligence at the ages of 4 and 8 years","volume":"118","author":"Gale","year":"2006","journal-title":"Pediatrics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.15585\/mmwr.mm6547e2","article-title":"Description of 13 infants born during October 2015-January 2016 with congenital Zika virus infection without microcephaly at birth-Brazil","volume":"65","author":"Pessoa","year":"2016","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1590\/1806-9304201600s100003","article-title":"Epileptic seizures in children with congenital Zika virus syndrome","volume":"16","author":"Alves","year":"2016","journal-title":"Rev. Bras. Saude. Matern Infant."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.clinph.2016.11.004","article-title":"Sleep EEG patterns in infants with congenital Zika virus syndrome","volume":"128","author":"Carvalho","year":"2017","journal-title":"Clin. Neurophysiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/epi.13709","article-title":"ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology","volume":"58","author":"Scheffer","year":"2017","journal-title":"Epilepsia"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s00401-015-1481-5","article-title":"Infections, inflammation and epilepsy","volume":"131","author":"Vezzani","year":"2016","journal-title":"Acta. Neuropathol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1111\/epi.12550","article-title":"ILAE official report: A practical clinical definition of epilepsy","volume":"55","author":"Fisher","year":"2014","journal-title":"Epilepsia"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/epi.16444","article-title":"Early epilepsy in children with Zika-related microcephaly in a cohort in Recife, Brazil: Characteristics, electroencephalographic findings, and treatment response","volume":"61","author":"Carvalho","year":"2020","journal-title":"Epilepsia"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ebcr.2018.09.002","article-title":"Epileptic spasms as the presenting seizure type in a patient with a new \u201cO\u201d of TORCH, congenital Zika virus infection","volume":"11","author":"Lockrow","year":"2019","journal-title":"Epilepsy Behav. Case Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/S0140-6736(00)40184-4","article-title":"On a peculiar form of infantile convulsions","volume":"1","author":"West","year":"1841","journal-title":"Lancet"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0387-7604(97)00085-5","article-title":"West syndrome: Etiological and prognostic aspects","volume":"20","author":"Watanabe","year":"1998","journal-title":"Brain Dev."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/mrdd.10035","article-title":"The epidemiology of the epilepsies in children","volume":"8","author":"Cowan","year":"2002","journal-title":"Ment. Retard. Dev. Disabil. Res. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.seizure.2015.01.001","article-title":"Long-term outcomes in patients with West syndrome: An outpatient clinical study","volume":"25","author":"Benbir","year":"2015","journal-title":"Seizure"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/S0387-7604(01)00312-6","article-title":"How do the many etiologies of West syndrome lead to excitability and seizures? The corticotropin releasing hormone excess hypothesis","volume":"23","author":"Brunson","year":"2001","journal-title":"Brain Dev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s40261-017-0595-z","article-title":"West Syndrome: A Review and Guide for Paediatricians","volume":"38","author":"Rigante","year":"2018","journal-title":"Clin. Drug Investig."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1002\/ana.20872","article-title":"Cognitive prognosis in chronic temporal 180 lobe epilepsy","volume":"60","author":"Hermann","year":"2006","journal-title":"Ann. Neurol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e204096","DOI":"10.1001\/jamanetworkopen.2020.4096","article-title":"Developmental Outcomes Among Young Children with Congenital Zika Syndrome in Brazil","volume":"3","author":"Wheeler","year":"2020","journal-title":"JAMA Netw. Open"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/12\/10\/1083\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:13:48Z","timestamp":1760177628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/12\/10\/1083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,25]]},"references-count":59,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["v12101083"],"URL":"https:\/\/doi.org\/10.3390\/v12101083","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,25]]}}}