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Microcephaly

Introduction

The nervous system is composed of two parts including the central nervous system (CNS) and peripheral nervous system (PNS). The central nervous system is made up of the brain and spinal cord while the peripheral is made up “of nerves that branch off from the spinal cord and extend to all parts of the body” (U.S. Department of Health and Human Services, 2018). With the help and communication between both neurons and non-neuronal glial cells, the nervous system functions to “respond to sensory stimuli, control muscles and some glands,” and is “responsible for consciousness, intelligence, and memory” (Mckinley, 2021).

Microcephaly is a neurological condition that results in a baby’s head developing significantly smaller than average. A baby with microcephaly’s brain does not grow “properly during pregnancy or has stopped growing after birth, which results in a smaller head size” (CDC, 2020). This condition can be either isolated with the disorder on its own or be combined with other birth defects in the womb. Microcephaly can also range in severity depending on how much the brain develops and if other damage occurs. There are various pathological causes (both environmental and genetic) for microcephaly including “craniosynostosis, genetic changes, cerebral anoxia, infections passed to the fetus during pregnancy, exposure to drugs, alcohol or certain toxic chemicals in the womb, severe malnutrition, and phenylketonuria” (Mayo Clinic, 2022). Congenital microcephaly “is characterized by neurotrophic infectious agents that involve the fetal nervous system, leading to brain destruction with calcifications, microcephaly, sensorineural hearing loss, and ophthalmologic abnormalities” (Frenkel, 2018). Microcephaly became a large topic of discussion in the research and medical world following the infamous Zika Virus outbreak in the Americas through 2015-2016. Although babies were born with the defect pre-Zika, a research study conducted in 2018 found that “in terms of the number of cases per 100,000 births, the incidence of microcephaly in the period after the Zika virus was introduced in the country (Mexico) was significantly higher than that in the period before introduction,” raising the incidence of congenital microcephaly from 3.7 to 11.5 per 100,000 births (Hernández-Ávila, 2018). This study suggested that mother’s contracting Zika Virus during pregnancy may have played a significant role in the increased numbers of babies developing microcephaly.

There is no standard life expectancy for microcephalic babies, however, “majority of kids with microcephaly will not grow up to be independent or able to live on their own” (Leonard, 2016) due to complications such as “developmental delays, difficulties with coordination and balance, dwarfism, facial distortions, hyperactivity, intellectual delays, and seizures” (Mayo Clinic, 2022).

Citations Monteiro, M. G. (2017, November 6). Efficacy of aquatic physiotherapy in children with microcephaly by Zika virus congenital syndrome - full text view. Full Text View - ClinicalTrials.gov. Retrieved October 31, 2022, from https://clinicaltrials.gov/ct2/show/NCT03330600?term=Microcephaly&draw=2&rank=7 Barra, G. B., & Sabin, L. (2016, April 18). Zika and microcephaly: Case-control study - full text view. Full Text View - ClinicalTrials.gov. Retrieved October 31, 2022, from https://clinicaltrials.gov/ct2/show/NCT02741882?term=Microcephaly&draw=2&rank=3 Centers for Disease Control and Prevention. (2020, October 23). Facts about craniosynostosis. Centers for Disease Control and Prevention. Retrieved October 31, 2022, from https://www.cdc.gov/ncbddd/birthdefects/craniosynostosis.html#:~:text=What%20is%20Craniosynostosis%3F-,Craniosynostosis%20is%20a%20birth%20defect%20in%20which%20the%20bones%20in,flexible%20material%20and%20called%20sutures. Centers for Disease Control and Prevention. (2020, October 23). Facts about microcephaly. Centers for Disease Control and Prevention. Retrieved October 31, 2022, from https://www.cdc.gov/ncbddd/birthdefects/microcephaly.html Deluca, S. (2021, March 25). Intensive therapy for children with microcephaly, hyperkinetic movements, or global developmental delay - full text view. Full Text View - ClinicalTrials.gov. Retrieved October 31, 2022, from https://clinicaltrials.gov/ct2/show/NCT04816175?term=Microcephaly&draw=2&rank=6 Evaluation of patients with unresolved chromosome abnormalities - full text view. Full Text View - ClinicalTrials.gov. (2002, December 10). Retrieved October 31, 2022, from https://clinicaltrials.gov/ct2/show/study/NCT00001639?term=Microcephaly&draw=7&rank=21 Frenkel LD, Gomez F, Sabahi F. The pathogenesis of microcephaly resulting from congenital infections: why is my baby's head so small? Eur J Clin Microbiol Infect Dis. 2018 Feb;37(2):209-226. doi: 10.1007/s10096-017-3111-8. Epub 2017 Oct 5. PMID: 28980148. Hernández-Ávila, J. E., Palacio-Mejía, L. S., López-Gatell, H., Alpuche-Aranda, C. M., Molina-Vélez, D., González-González, L., & Hernández-Ávila, M. (2018, May 1). Zika virus infection estimates, Mexico. Bulletin of the World Health Organization. Retrieved December 1, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985421/#:~:text=In%20contrast%2C%20during%20the%20period,12.6)%20cases%20per%20100%20000. Leonard, K. (2016, March 4). Microcephaly: After diagnosis, a life of uncertainty - US news & world ... U.S. News. Retrieved November 1, 2022, from https://www.usnews.com/news/articles/2016-03-04/microcephaly-after-diagnosis-a-life-of-uncertainty Mayo Foundation for Medical Education and Research. (2022, May 26). Microcephaly. Mayo Clinic. Retrieved October 31, 2022, from https://www.mayoclinic.org/diseases-conditions/microcephaly/diagnosis-treatment/drc-20375056 Mckinley, Michael (2021). Anatomy and physiology an integrative approach (4th ed.). MCGRAW-HILL US HIGHER ED. Microcephaly in Children, Stanford Medicine Children's Health, https://www.stanfordchildrens.org/en/topic/default?id=microcephaly-90-P02610. “Microcephaly.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 26 May 2022, https://www.mayoclinic.org/diseases-conditions/microcephaly/diagnosis-treatment/drc-20375056 ScienceDaily. (2016, August 5). Microcephaly discoveries made in non-Zika cases help explain abnormal brain growth. ScienceDaily. Retrieved December 1, 2022, from https://www.sciencedaily.com/releases/2016/08/160805092232.htm U.S. Department of Health and Human Services. (2018, October 1). What are the parts of the nervous system? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Retrieved October 31, 2022, from https://www.nichd.nih.gov/health/topics/neuro/conditioninfo/parts