NEUROLOGICAL MANIFESTATIONS OF CONGENITAL RUBELLA INFECTION

Abstract

Congenital rubella is a disease caused by infection with the rubella virus during pregnancy, which can cause serious fetal malformations, such as deafness, cataracts, retinopathy, microcephaly, heart disease and mental retardation. The neurological manifestations of congenital rubella infection are varied and can affect both the central and peripheral nervous systems. Some of the most common neurological complications are encephalitis, meningitis, hydrocephalus, intracranial calcification, cerebral atrophy, epilepsy, cerebral palsy, peripheral neuropathy and Guillain-Barré syndrome. Objective: to evaluate the scientific evidence on the neurological manifestations of congenital rubella infection, as well as the risk factors, diagnosis, treatment and prevention of this condition. Methodology: The methodology of this review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, which consists of a series of criteria to guarantee the quality and transparency of systematic reviews. Searches were carried out in the PubMed, Scielo and Web of Science databases, using the following descriptors: “rubella”, “congenital rubella”, “neurological manifestations”, “neurological complications” and “neurodevelopmental disorders”. Only articles published in the last 10 years (2013-2023), in Portuguese or English, that addressed the neurological manifestations of congenital rubella infection in humans were included. Articles that were not original (reviews, editorials, letters), that did not have sufficient or reliable data, that were duplicated or that were not related to the topic were excluded. Results: 15 studies were selected. The epidemiology of congenital rubella in the world and in Brazil, highlighting the importance of vaccination for the elimination of the disease. The pathogenic mechanisms of congenital rubella infection in the nervous system, involving viral replication, immune response, inflammation and apoptosis. Risk factors for the development of neurological manifestations of congenital rubella infection, such as the gestational period of infection, maternal viral load, viral genotype and clinical conditions of the mother and fetus. Diagnostic methods of congenital rubella infection and its neurological manifestations, including serological, molecular, imaging and neurological tests. Conclusion: The conclusion of this review was that the neurological manifestations of congenital rubella infection are serious and frequent, and can affect several aspects of child development. Prevention is the best strategy to avoid this condition, and adequate immunization of women of childbearing age and children is essential. Early diagnosis and appropriate treatment can reduce neurological sequelae and improve the prognosis of cases.