Abstract Details

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9/26/2014  |   11:15 AM - 11:45 AM   |  Ballroom A

Impaired balance and neurodevelopmental disabilities among children with congenital cytomegalovirus infection

Introduction: In addition to the risk of acquired hearing impairment, congenital CMV infection is also a risk factor for other neuro¬logical disabilities such as epilepsy, cognitive deficits and motor deficits, including cerebral palsy. Visual impairment occurs after congenital CMV infection but is seldom reported. Autism spectrum disorders and attention deficit hyperactivity disorder have been reported by only a few authors. Speech and language disorders as well as balance im¬pairment have also been reported as sequele of CMV. No studies however have thoroughly evaluated the characteristics of vestibular end-organ dysfunction which leads to the balance disturbance in the setting of congenital CMV related hearing impairment. Identi¬fication of comorbid conditions is of utmost importance, as children with associated difficul¬ties and disabilities need more support in daily life than children that have hearing impairment alone. Aim: The aim of this study was to evaluate disabilities in a well-defined group of children with congenital cytomegalovirus (CMV) infection and severe hearing impairment, treated with cochlear implants. Methods: A case-control study where 26 children with congenital CMV infection were assessed by a multidisciplinary team for balance difficulties, neurodevelopmental disabilities and for language and visual impairment. As controls served 13 children with severe hearing impairment due to connexin 26 mutations. Results: The children with congenital CMV infection had significantly higher frequency of balance disturbances (88%) compared to the control group, in which no children showed such disturbances. Moreover, neurodevelop¬mental disabilities and feeding difficulties were frequent among the children with congenital CMV infection. Conclusion: Congenital CMV infection affects the general development of the brain and gives rise to a complex pattern of difficulties. In children with hearing impairment and/or balance disturbance and/or neurodevelop¬mental disabilities, congenital CMV infection needs to be considered.

Eva Karltorp (Point of Contact,Primary Presenter), eva.karltorp@karolinska.se;
Eva Karltorp is MD and PhD and specialist in otorhinolaryngoly and audiology. Since 2004 she is in charge of the Cochlear implant team at the ENT clinic at Karolinska university hospital. The cochlear implant team has both an adult and a pediatric program. The pediatric program serves more than 50 % of the Swedish population, with around 30-40 new children receiving implants each year. Up to now 490 children have received implants at our centre and of those 270 are bilaterally operated. Eva´s main research interests are cytomegalovirus (CMV) infection as a cause of hearing deficit, early cochlear implantation and bilateral implantation. Her most recent project is about hearing impaired children with congenital CMV infection. The study will hopefully contribute to the question to which extent the children have other neurological disabilities beside their hearing impairment.

ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.

Katarina Hedman Lindström (Author), katarina.hedman-lindstrom@karolinska.se;
Katarina Hedman Lindström, MD and PhD, is a neuropediatrician at the division of pediatrics, Karolinska University Hospital with a special interest in neurodevelopmental diseases.

Ilona Lewensohn-Fuchs (Author), ilona.lewensohn-fuchs@karolinska.se;
Ilona Lewensohn-Fuchs, MD and associate professor, is a clinical virologist at the department of Clinical Microbiology, Karolinska university hospital.

Kristina Teär Fahnehjelm (Author), kristina.tear-fahnehjelm@ki.se;
Kristina Teär Fahnehjelm, MD and associate professor, is an ophthalmologist at St Eriks Eye hospital(at the time of the study), Karolinska university hospital.

Mimmi Eriksson Westblad (Author), mimmi.eriksson-westblad@karolinska.se;
Mimmi Eriksson Westblad, is a physiotherapist at dept of Physiotherapy, Karolinska university hospital, mainly working with late developed children.

Ulrika Löfkvist (Author), ulrika.lofkvist@karolinska.se;
Ulrika Löfkvist,PhD, is a speech and language pathologist at dept of Speech and language pathology, Karolinska university hospital. Her field of interest is early language cognitive development among hearing impaired children.

Luca Verrecchia (Author), luca.verrecchia@karolinska.se;
Luca Verrecchia, MD and PhD student, is an otolaryngologist at the dept of Audiology and Neurotology at Karolinska university hospital, with balance disorders as his main field of interest.

Mona-Lisa Engman (Author), mona-lisa.engman@karolinska.se;
Mona-Lisa Engman, MD and PhD, is a pediatrician at the division of Pediatrics, Karolinska University Hospital. Her research interests include all neonatal infections and tick-borne encephalitis. All authors were part of the multidisciplinary team conduction the study.

Presentation:
533EvaKarltorp.pdf

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