ASYMPTOMATIC CONGENITAL CMV: CT AND ABR ABNORMALITIES

Abstract

Five infants with asymptomatic congenital CMV documented by urine culture in the first week of life were evaluated in a prospective study of the relationship between maternal CMV serology during pregnancy and neurodevelopmental outcome of the infant. Initial assessment at 1 week to 3 months of age consisted of unenhanced cranial CT scan, ABR, and neurologic exam, with reassessment at 6-9 months of age. Three of the 5 infants had abnormalities on one or more of these exams. Two infants had abnormal lucency of the cerebral white matter on CT scan; on subsequent scans, one had mildly dilated lateral ventricles and one had no abnormalities. Both infants were mildly hypotonic and had abnormal ABR's characterized by prolonged Wave V latencies and Wave I-V intervals (≥2 S.D. above mean for age, Salamy and McKean, Electro Clin Neuro, 1976), with Wave I latency. Serial ABR's revealed gradual decrease in latency times to limits by 6-9 months of age. A third infant had both an abnormal CT scan (abnormally prominent interhemispheric fissure and cisternal spaces), but ABR. In the absence of other perinatal risk factors, three normal infants had CT, ABR and/or neurologic abnormalities which may be related to the in utero CMV infection. However, the pathophysiology and long term significance of these findings are not clear. Longitudinal assessment will be essential to define the full impact of in utero exposure to CMV.