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The impact of undernutrition and overnutrition on early brain development 营养不良和营养过剩对早期大脑发育的影响

IF 2.1 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101212

Ana Cabal-Herrera , Barnabas Kigen , Esperancia Kapanga , Alex Samia , Helen Nabwera , Pauline Samia

In this review, we explore the effects of malnutrition on childhood neurodevelopment. Early brain development is highly sensitive to nutritional status. Both undernutrition and overnutrition can disrupt critical neurodevelopmental processes, affecting cognition, emotional regulation, and long-term mental health. Nutrient deficiencies, such as iron, iodine, folate, and vitamin B12, have been linked to impaired brain growth and function. Similarly, excessive caloric intake can also negatively impact brain development as it may contribute to neuroinflammation and altered neurocircuitry. The effects are most pronounced during prenatal life and early childhood, with lasting consequences on academic performance, behavior, and productivity. In addition to health-related outcomes, undernutrition and overnutrition can also have significant social and financial repercussions for individuals and their communities. This review synthesizes current insights on the relationship between nutrition and brain development, explores specific nutrient effects, and highlights the role of public health interventions. Addressing both undernutrition and overnutrition through early and targeted action is essential for optimizing neurodevelopment and reducing the long-term societal burden of cognitive and mental health disorders. Continuous monitoring of both existing and emerging nutritional deficiencies is necessary, particularly in marginalized communities and low- and middle-income regions, where the risk of undernutrition remains high.

在这篇综述中，我们探讨营养不良对儿童神经发育的影响。早期大脑发育对营养状况非常敏感。营养不良和营养过剩都会破坏关键的神经发育过程，影响认知、情绪调节和长期心理健康。营养缺乏，如铁、碘、叶酸和维生素B12，与大脑发育和功能受损有关。同样，过量的热量摄入也会对大脑发育产生负面影响，因为它可能会导致神经炎症和神经回路的改变。这种影响在产前和儿童早期最为明显，对学习成绩、行为和生产力都有持久的影响。除了与健康有关的后果外，营养不良和营养过剩还可能对个人及其社区产生重大的社会和经济影响。这篇综述综合了目前关于营养与大脑发育之间关系的见解，探讨了特定的营养效应，并强调了公共卫生干预的作用。通过早期和有针对性的行动解决营养不良和营养过剩问题，对于优化神经发育和减少认知和精神健康障碍的长期社会负担至关重要。有必要持续监测现有和新出现的营养缺乏症，特别是在营养不足风险仍然很高的边缘化社区和低收入和中等收入地区。

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引用次数: 0

Genetic testing for infantile-onset epilepsies in resource-limited settings 在资源有限的环境中进行幼儿癫痫的基因检测

IF 2.1 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101204

Priyanka Srivastava , Sandeep Negi , Melissa Baltuano , Carolina Reynoso , Ahmad Rithauddin Bin Mohamed , Jitendra Kumar Sahu

Infantile-onset epilepsies, a heterogenous group of epilepsies with onset up to two years of age, constitute a significant burden in developing countries and frequently result from various genetic variations. The phenomena of genetic heterogeneity and phenotypic pleiotropy are observed across epilepsy syndromes of infantile-onset epilepsies. In the current era of precision-based medicine, early genetic diagnosis and targeted management can significantly influence epilepsy and developmental outcomes. Despite rapid advancement in genetic testing, access to genetic diagnostic facilities is a global challenge, especially in resource-limited settings. The major barriers to genetic diagnosis are high costs, limited access to specialized laboratories, and the need for expert interpretation. Nevertheless, strategies like targeted gene panels, collaborations with reference laboratories, and clinical phenotyping can help maximize the diagnostic yield while considering resource constraints. Investments in infrastructure, policy support, and international collaboration can bridge the gap and ensure that affected children receive timely and accurate diagnoses. This review discusses the importance, challenges, and potential strategies for integrating genetic testing in resource-limited environments, emphasizing the need for affordable and accessible solutions that can enhance patient care.

婴儿癫痫是一组异质性癫痫，发病年龄可达两岁，在发展中国家构成重大负担，往往由各种遗传变异引起。在婴幼儿癫痫综合征中观察到遗传异质性和表型多效性现象。在当前精准医学时代，早期遗传诊断和有针对性的管理可以显著影响癫痫和发育结局。尽管基因检测进展迅速，但获得基因诊断设施是一项全球性挑战，特别是在资源有限的情况下。遗传诊断的主要障碍是费用高，进入专门实验室的机会有限，以及需要专家解释。然而，考虑到资源限制，诸如靶向基因小组、与参考实验室合作和临床表型等策略可以帮助最大限度地提高诊断产量。对基础设施、政策支持和国际合作的投资可以弥补这一差距，确保受影响的儿童得到及时和准确的诊断。这篇综述讨论了在资源有限的环境中整合基因检测的重要性、挑战和潜在的策略，强调需要负担得起和可获得的解决方案，以加强患者护理。

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引用次数: 0

The challenges of establishing centers for the surgical management of epilepsy in low- and middle-income countries 在低收入和中等收入国家建立癫痫外科治疗中心的挑战

IF 2.1 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101224

Jorge Vidaurre , Juan C Pérez-Poveda , Manuel Campos-Puebla , Pedro Weisleder

Epilepsy affects over 50 million individuals globally, with more than 80 % residing in resource-limited countries. While the majority of patients achieve seizure control with antiseizure medications, approximately one-third are diagnosed with drug-resistant epilepsy (DRE). For these individuals, epilepsy surgery represents a potentially effective therapeutic option. Expert consensus from the Surgical Therapies Commission of the International League Against Epilepsy (ILAE) recommends prompt referral for surgical evaluation upon diagnosis of DRE. Nevertheless, despite substantial supporting evidence, such referrals are frequently delayed—particularly in low- and middle-income countries (LMICs). This article examines the barriers to timely surgical evaluation and explores strategies to facilitate the development of epilepsy surgery programs in resource-constrained settings.

癫痫影响全球5000多万人，其中80%以上居住在资源有限的国家。虽然大多数患者通过抗癫痫药物实现癫痫控制，但大约三分之一的患者被诊断为耐药癫痫（DRE）。对于这些人来说，癫痫手术是一种潜在有效的治疗选择。国际抗癫痫联盟（ILAE）外科治疗委员会的专家一致建议在诊断DRE后立即转诊进行手术评估。然而，尽管有大量的支持证据，这种转诊经常被推迟，特别是在低收入和中等收入国家。本文探讨了及时手术评估的障碍，并探讨了在资源有限的情况下促进癫痫手术项目发展的策略。

引用次数: 0

Diagnostic and treatment gaps 诊断和治疗差距

IF 2.1 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101200

Cyprian Birmeh , Obrey H. Urio , Jo M. Wilmshurst

The epilepsy treatment gap in low- and middle-income countries especially sub-Saharan countries is substantial, driven by socioeconomic challenges, inadequate infrastructure, and limited access to diagnosis, treatment and care. The diagnostic gap further compounds this, with many patients remaining undiagnosed or misdiagnosed due to lack of skilled healthcare professionals, inadequate diagnostic facilities, and limited access to specialized care.

A comprehensive approach that uses sustainable solutions, prioritizing local ownership, capacity building and community engagement are crucial for bridging the epilepsy treatment and diagnostic gaps. This includes a collaborative effort between the neurology community and opinion leaders as well as policy makers.

Targeted solutions such as training more neurologists through locally relevant programs and training of primary and community healthcare workers for task-shifting and task-sharing interventions. Also strengthening supply chains and procurement processes to ensure constant supply of affordable antiseizure medications. It is critical to promote leveraging of technology such as use of smartphone video recordings, remote EEG and telemedicine tools. Further collection of data is needed inclusive of registries for disease burden, to enhance consistency in diagnostic categorization, follow up and understandings of supply chain efficiency. Overlying these clinical interventions implementation of public awareness campaigns and policy reforms to reduce stigma and promote inclusivity are critical for bridging the epilepsy treatment and diagnostic gaps.

Research should focus on understanding the socioeconomic and public health factors contributing to the treatment and diagnostic gaps, and evaluating the effectiveness of rolled-out interventions.

在低收入和中等收入国家，特别是撒哈拉以南国家，由于社会经济挑战、基础设施不足以及获得诊断、治疗和护理的机会有限，癫痫治疗差距很大。诊断差距进一步加剧了这种情况，由于缺乏熟练的卫生保健专业人员、诊断设施不足以及获得专门护理的机会有限，许多患者仍未得到诊断或误诊。采用可持续解决办法、优先考虑地方自主权、能力建设和社区参与的综合办法对于弥合癫痫治疗和诊断差距至关重要。这包括神经病学社区和意见领袖以及决策者之间的合作努力。有针对性的解决方案，如通过当地相关项目培训更多的神经科医生，培训初级和社区卫生保健工作者进行任务转移和任务分担干预。加强供应链和采购流程，确保持续供应负担得起的抗癫痫药物。促进利用智能手机录像、远程脑电图和远程医疗工具等技术至关重要。需要进一步收集包括疾病负担登记在内的数据，以加强诊断分类的一致性、后续行动和对供应链效率的理解。在这些临床干预措施的基础上，开展公众意识运动和政策改革，以减少耻辱感和促进包容性，对于缩小癫痫治疗和诊断差距至关重要。研究应侧重于了解造成治疗和诊断差距的社会经济和公共卫生因素，并评估已推出的干预措施的有效性。

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引用次数: 0

Investigating the burden of cerebral palsy in low- and middle-income countries: Implications and priorities for pediatric neurology 调查低收入和中等收入国家脑瘫负担：小儿神经病学的影响和重点

IF 2.1 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101225

Harshitha Valluri , Mugdha Mohanty , Carlos Ramirez Mongil , Griselda Fuentes , Tipu Sultan , Alcy R. Torres

Cerebral Palsy (CP) is the most common pediatric physical disability worldwide presenting as a non-progressive motor dysfunction due to insults to the developing brain. While CP has a higher prevalence and burden in low- and middle-income countries, the most extensive research towards care and management of the patients with CP has been conducted in high-income countries. There is a disparate impact on CP from resource limited countries due to insufficient healthcare resources, barriers to healthcare access, inadequate public health awareness, and lack of accurate data.

In this article we examine the state of CP in low- and middle-income countries. We explore the multitude of environmental, socioeconomic, and infrastructural factors that contribute to the clinical profile of CP in these regions.

Finally, we high

light the primary areas of burden that need to be addressed in low- and middle-income countries: inadequate healthcare infrastructure and resources, lack of registries, social stigma with the and limited public health education, and strain on primary caregivers.

脑瘫（CP）是世界上最常见的儿童身体残疾，表现为由于发育中的大脑受到损伤而导致的非进行性运动功能障碍。虽然CP在低收入和中等收入国家的患病率和负担较高，但对CP患者的护理和管理进行的最广泛的研究是在高收入国家进行的。由于卫生保健资源不足、获得卫生保健的障碍、公众卫生意识不足以及缺乏准确的数据，资源有限的国家对CP的影响各不相同。在本文中，我们研究了低收入和中等收入国家的CP状况。我们探讨了环境、社会经济和基础设施因素对这些地区CP临床概况的影响。最后，我们强调了低收入和中等收入国家需要解决的主要负担领域：医疗基础设施和资源不足，缺乏登记，公共卫生教育的社会耻辱和有限，以及初级护理人员的压力。

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引用次数: 0

Impact of advocacy and private foundations in improving treatment of epilepsy in resource limited regions 宣传和私人基金会在资源有限地区改善癫痫治疗方面的影响

IF 2.1 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101199

Rebeca Figueroa Diaz , Angel Hernandez

Epilepsy treatment in resource-limited countries faces numerous challenges including limited access to antiepileptic drugs (AEDs), inadequate healthcare infrastructure, and social stigma. Advocacy efforts and private foundations play a vital role in addressing these barriers and improving epilepsy care outcomes. Global health projects focusing on clinical care, research, education, and advocacy have emerged to address the significant epilepsy treatment gap in low- and middle-income countries (LMICs). These collaborative initiatives aim to develop sustainable solutions, such as enhancing epilepsy care in marginalized communities and implementing strategies to mitigate treatment gaps and improve access to healthcare. The use of primary healthcare personnel to identify epilepsy cases and initiate simple treatment protocols has shown promise in addressing the shortage of specialized medical professionals in developing countries. Advocacy and private foundations focus on educating healthcare providers, increasing public awareness, improving drug availability, and developing cost-effective epilepsy surgery programs. However, challenges remain, including the need for country-specific assessments and the development of comprehensive epilepsy care models that consider the heterogeneity of the disorder and its impact on patients, families, and communities.

在资源有限的国家，癫痫治疗面临着许多挑战，包括获得抗癫痫药物有限、卫生保健基础设施不足和社会污名化。宣传工作和私人基金会在解决这些障碍和改善癫痫治疗结果方面发挥着至关重要的作用。已经出现了侧重于临床护理、研究、教育和宣传的全球卫生项目，以解决低收入和中等收入国家在癫痫治疗方面的巨大差距。这些合作举措旨在制定可持续的解决办法，例如加强边缘化社区的癫痫护理，并实施战略，以缩小治疗差距和改善获得卫生保健的机会。利用初级保健人员确定癫痫病例并制定简单的治疗方案，有望解决发展中国家专业医疗人员短缺的问题。倡导和私人基金会的重点是教育卫生保健提供者，提高公众意识，改善药物供应，并制定具有成本效益的癫痫手术方案。然而，挑战仍然存在，包括需要针对具体国家进行评估，并制定综合癫痫护理模式，考虑到该病的异质性及其对患者、家庭和社区的影响。

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引用次数: 0

Management of cerebral palsy in low- and middle-income countries 低收入和中等收入国家脑瘫的管理

IF 2.1 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101202

Edward Kija , Tracy Tushabe Namata , Robert Sebunya

Cerebral Palsy (CP) is the most common cause of childhood disability globally with a higher prevalence in low and middle-income countries (LMIC). Hypoxic-ischemic encephalopathy (HIE) caused by preventable perinatal insults is still the leading cause of CP in LMIC. Spastic quadriplegic CP is the most common subtype in LMIC accounting for 70-80 % of cases. Lack of awareness compounded by stigma delays initiation of intervention leading to a poorer outcome and reduced quality of. The comprehensive management of children with CP requires an interdisciplinary team of experts. Such expertise is often lacking in LMIC. When available, its distribution is largely skewed towards urban areas. Although there is a higher burden of comorbidities, screening and diagnosis of the related conditions are inadequate, leading to poor management. Surgical interventions such as intrathecal baclofen, selective dorsal rhizotomy for spasticity and gastrostomy tube insertion for children with severe gastroesophageal reflux disease is often limited by costs and shortage number of trained personnel. Evidence-based local guidelines are essential for managing children with CP, guiding government investments to improve the quality of life for entire families. Concerted efforts in healthcare system reforms, policymakers, community engagement and awareness to enhance early diagnosis and appropriate referral, management through locally generated evidence-based interventions are required in LMIC to improve care among of children with CP and their families.

脑瘫是全球儿童残疾最常见的原因，在低收入和中等收入国家发病率较高。由可预防的围产期损伤引起的缺氧缺血性脑病（HIE）仍然是LMIC中CP的主要原因。痉挛性四肢瘫痪CP是LMIC中最常见的亚型，占70- 80%的病例。缺乏认识，加上耻辱感，延误了干预措施的启动，导致结果较差，服务质量下降。对CP患儿的综合管理需要一个跨学科的专家团队。低收入和中等收入国家往往缺乏这种专门知识。即使有，其分布也主要向城市地区倾斜。虽然合并症的负担较高，但相关疾病的筛查和诊断不足，导致管理不善。手术干预，如鞘内巴氯芬、选择性背根切断术治疗痉挛和胃造口管插入治疗严重胃食管反流病的儿童，往往受到成本和训练有素的人员数量不足的限制。以证据为基础的地方指南对于管理CP儿童、指导政府投资以改善整个家庭的生活质量至关重要。低收入和中等收入国家需要在卫生保健系统改革、政策制定者、社区参与和意识方面共同努力，加强早期诊断和适当转诊，并通过当地产生的循证干预措施进行管理，以改善对CP儿童及其家庭的护理。

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引用次数: 0

Etiology and diagnosis of cerebral palsy in resource-limited regions 资源有限地区脑瘫的病因和诊断

IF 2.1 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101226

Pratibha Singhi , Arushi Gahlot Saini

The prevalence of cerebral palsy (CP) is greater in resource limited countries than in higher income countries for several reasons. The etiology and risk factors for cerebral palsy are multifactorial, including perinatal, vascular, infectious, and genetic factors with significant regional variations. Whereas advancements in neonatal care and early intervention have improved outcomes in high-income countries, the burden of CP remains disproportionately high in resource-limited regions due to delayed diagnosis, inadequate access to specialized healthcare, and socioeconomic constraints. Early diagnosis of CP is crucial for timely intervention, which can significantly improve motor and cognitive outcomes. In low-resource settings, limited availability of trained healthcare professionals, lack of standardized screening tools, and inadequate neonatal follow-up programs can hinder early identification. Additionally, social and cultural norms can contribute to delayed medical attention, further exacerbating disability in affected children.

This article explores the etiology and diagnostic challenges of CP in resource-limited regions, emphasizing the unique risk factors and diagnostic challenges prevalent in these settings. Potential low-cost solutions for early diagnosis and intervention, including the use of simple clinical assessment tools, mobile health technology, and community-based rehabilitation strategies are also discussed. Addressing these challenges through cost-effective, scalable and sustainable interventions can improve outcomes for children with CP, reducing the long-term economic and social burden on families and healthcare systems.

由于若干原因，资源有限的国家脑瘫患病率高于高收入国家。脑瘫的病因和危险因素是多因素的，包括围生期、血管、感染和遗传因素，具有显著的区域差异。尽管新生儿护理和早期干预的进步改善了高收入国家的结果，但在资源有限的地区，由于诊断延迟、获得专业医疗服务的机会不足以及社会经济制约，CP的负担仍然过高。早期诊断对及时干预至关重要，可显著改善运动和认知预后。在资源匮乏的环境中，训练有素的医疗保健专业人员有限，缺乏标准化的筛查工具，以及不充分的新生儿随访计划可能会阻碍早期识别。此外，社会和文化规范可能导致医疗护理延迟，进一步加剧受影响儿童的残疾。本文探讨了资源有限地区CP的病因学和诊断挑战，强调了这些地区普遍存在的独特风险因素和诊断挑战。还讨论了早期诊断和干预的潜在低成本解决方案，包括使用简单的临床评估工具、移动卫生技术和基于社区的康复战略。通过具有成本效益、可扩展和可持续的干预措施来应对这些挑战，可以改善CP儿童的预后，减轻家庭和卫生保健系统的长期经济和社会负担。

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引用次数: 0

AIDS virus 艾滋病病毒

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101205

Charles K. Hammond , Perpetual Kanzie , Charles Martyn-Dickens , Edward Ebo Ocran

HIV affects both the central and peripheral nervous systems, resulting in a wide range of neurological complications due to direct viral effects, chronic inflammation, opportunistic infections, and adverse effects of antiretroviral therapy (ART), collectively referred to as neuroAIDS. In children, the underdeveloped blood-brain barrier heightens the vulnerability of the brain to neuroAIDS, impacting cognitive and motor development. Even HIV-exposed, uninfected children exhibit neurodevelopmental delays.

Chronic infection leads to a sustained viral presence in the cerebrospinal fluid, resulting in neuroinflammation. HIV encephalopathy (HIVE) remains a major concern, causing developmental regression, cognitive impairment, and motor dysfunction. Although the prevalence of HIVE has declined with the advent of combination antiretroviral therapy, rates remain high in low-resource settings.

Opportunistic infections such as tuberculous meningitis, viral encephalitis, and fungal infections are prevalent among children with HIV-AIDS. Children with HIV are also at risk for cerebrovascular diseases, neurocognitive impairments, and neuropsychiatric conditions such as mood disorders and high-risk behaviors. Epilepsy and peripheral neuropathy are more common in children with HIV, with ART regimens sometimes contributing to neuropathy.

Early ART initiation remains crucial in improving neurodevelopmental outcomes. Careful drug selection and adequate treatment of opportunistic infections before ART initiation are important to prevent drug-drug interactions and immune reconstitution inflammatory syndrome, respectively. While treatment progress has improved neurological outcomes, disparities in access to healthcare continue to impact children in resource-limited settings.

HIV影响中枢和周围神经系统，由于病毒的直接作用、慢性炎症、机会性感染和抗逆转录病毒治疗（ART）的不良反应，导致广泛的神经系统并发症，统称为神经艾滋病。在儿童中，不发达的血脑屏障增加了大脑对神经艾滋病的脆弱性，影响了认知和运动发育。即使是接触艾滋病毒的未感染儿童也表现出神经发育迟缓。慢性感染导致脑脊液中持续存在病毒，导致神经炎症。HIV脑病（HIVE）仍然是一个主要的问题，引起发育倒退，认知障碍和运动功能障碍。尽管HIVE的流行率随着抗逆转录病毒联合治疗的出现而下降，但在资源匮乏的环境中仍然很高。机会性感染，如结核性脑膜炎、病毒性脑炎和真菌感染在艾滋病毒/艾滋病儿童中普遍存在。感染艾滋病毒的儿童也有患脑血管疾病、神经认知障碍和神经精神疾病（如情绪障碍和高危行为）的风险。癫痫和周围神经病变在感染艾滋病毒的儿童中更为常见，抗逆转录病毒治疗方案有时会导致神经病变。早期开始抗逆转录病毒治疗对于改善神经发育结果仍然至关重要。在开始抗逆转录病毒治疗之前仔细选择药物和充分治疗机会性感染分别对预防药物-药物相互作用和免疫重建炎症综合征很重要。虽然治疗进展改善了神经系统预后，但在资源有限的环境中，获得医疗保健方面的差距继续影响着儿童。

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引用次数: 0

Congenital toxoplasmosis 先天性弓形体病

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101203

Alfredo Cerisola , María Francia , Juan Pablo Gesuele

Toxoplasma gondii, one of the most prevalent zoonotic parasites globally, may be transmitted to the fetus if a primary infection occurs during pregnancy. The earlier the gestational period, the lower the probability of transmission, but if it occurs, the higher the probability of pregnancy loss or severe fetal neurological or ocular damage. Primary prevention measures to pregnant women include avoiding eating or handling raw or undercooked meat, washing hands thoroughly after gardening, avoid handling contaminated soil or water or come in contact with cat feces. The infected fetus may exhibit a broad spectrum of clinical manifestations, ranging from death in utero, stillbirths, symptomatic neonatal forms with systemic involvement and/or severe and irreversible ocular or neurological damage, to asymptomatic forms. Neurological manifestations include macro- or microcephaly, hydrocephalus, intracranial calcifications, abnormal muscle tone, cerebral palsy, global developmental delay, sensorineural hearing loss, and epilepsy. The whole clinical picture of each patient with congenital toxoplasmosis depends on a variable combination of different factors including: (a) gestational age at which the maternal infection has occurred and transmitted to the fetus, (b) disease detection: were pregnant women systematically screened during pregnancy, and if so, the frequency of serological tests, (c) if infected pregnant women and neonates were treated and timing and doses of the anti-T. gondii drugs used, (d) differences in the parasite load and in virulence of the genotype of the implicated T gondii strains, (e) individual maternal immune response, and f) presence of specific clinical features such as ventriculomegaly, multiple calcifications and retinochoroiditis.

刚地弓形虫是全球最流行的人畜共患寄生虫之一，如果在怀孕期间发生原发性感染，可能会传播给胎儿。妊娠期越早，传播概率越低，但一旦发生，流产或严重胎儿神经或眼部损伤的概率就越高。孕妇的初级预防措施包括避免食用或处理生肉或未煮熟的肉，在园艺后彻底洗手，避免处理受污染的土壤或水或接触猫的粪便。受感染的胎儿可能表现出广泛的临床表现，从宫内死亡、死产、全身受累和/或严重且不可逆的眼或神经损伤的新生儿症状，到无症状形式。神经学表现包括大头或小头畸形、脑积水、颅内钙化、异常肌张力、脑瘫、整体发育迟缓、感音神经性听力损失和癫痫。每个先天性弓形虫病患者的整个临床情况取决于不同因素的可变组合，包括：(a)母体感染并传播给胎儿的胎龄；(b)疾病检测：孕妇在怀孕期间是否进行了系统筛查，如果是，血清学检测的频率；(c)感染的孕妇和新生儿是否接受了治疗，以及抗t抗体的时间和剂量。使用的弓形虫药物，（d)涉及弓形虫菌株基因型的寄生虫载量和毒力差异，(e)个体母体免疫反应，以及f）存在特定的临床特征，如心室肿大、多发性钙化和视网膜脉管炎。

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引用次数: 0