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. 2022 May 11;107(6):630-636.
doi: 10.1136/archdischild-2021-323380. Online ahead of print.

Vestibular and balance dysfunction in children with congenital CMV: a systematic review

Annalie Shears #  1   2 , Georgina Yan #  3   4 , Harriet Mortimer  5 , Elizabeth Cross  6   7 , Shari Sapuan  8 , Seilesh Kadambari  9   10 , Suzanne Luck  11 , Paul T Heath  8 , Simone Walter  12 , Katy J Fidler  2   7
Affiliations

Vestibular and balance dysfunction in children with congenital CMV: a systematic review

Annalie Shears et al. Arch Dis Child Fetal Neonatal Ed. .

Abstract

Objective: This systematic review evaluates vestibular and balance dysfunction in children with congenital cytomegalovirus (cCMV), makes recommendations for clinical practice and informs future research priorities.

Design: MEDLINE, Embase, EMCARE, BMJ Best Practice, Cochrane Library, DynaMed Plus and UpToDate were searched from inception to 20 March 2021 and graded according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria.

Patients: Children with cCMV diagnosed within 3 weeks of life from either blood, saliva and/or urine (using either PCR or culture).

Intervention: Studies of vestibular function and/or balance assessments.

Main outcome measures: Vestibular function and balance.

Results: 1371 studies were identified, and subsequently 16 observational studies were eligible for analysis, leading to an overall cohort of 600 children with cCMV. All studies were of low/moderate quality. In 12/16 studies, vestibular function tests were performed. 10/12 reported vestibular dysfunction in ≥40% of children with cCMV. Three studies compared outcomes for children with symptomatic or asymptomatic cCMV at birth; vestibular dysfunction was more frequently reported in children with symptomatic (22%-60%), than asymptomatic cCMV (0%-12.5%). Two studies found that vestibular function deteriorated over time: one in children (mean age 7.2 months) over 10 months and the other (mean age 34.7 months) over 26 months.

Conclusions: Vestibular dysfunction is found in children with symptomatic and asymptomatic cCMV and in those with and without hearing loss. Audiovestibular assessments should be performed as part of neurodevelopmental follow-up in children with cCMV. Case-controlled longitudinal studies are required to more precisely characterise vestibular dysfunction and help determine the efficacy of early supportive interventions.

Prospero registration: CRD42019131656.

Keywords: Child Health; Deafness; Epidemiology; Neonatology; Virology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flow diagram of literature search. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
See this image and copyright information in PMC

References

    1. Kenneson A, Cannon MJ. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol 2007;17:253–76. 10.1002/rmv.535 - DOI - PubMed
    1. Dollard SC, Grosse SD, Ross DS. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol 2007;17:355–63. 10.1002/rmv.544 - DOI - PubMed
    1. Ssentongo P, Hehnly C, Birungi P, et al. . Congenital cytomegalovirus infection burden and epidemiologic risk factors in countries with universal screening: a systematic review and meta-analysis. JAMA Netw Open 2021;4:e2120736. 10.1001/jamanetworkopen.2021.20736 - DOI - PMC - PubMed
    1. Dreher AM, Arora N, Fowler KB, et al. . Spectrum of disease and outcome in children with symptomatic congenital cytomegalovirus infection. J Pediatr 2014;164:855–9. 10.1016/j.jpeds.2013.12.007 - DOI - PMC - PubMed
    1. Huygen PL, Admiraal RJ, Admiraal RJC. Audiovestibular sequelae of congenital cytomegalovirus infection in 3 children presumably representing 3 symptomatically different types of delayed endolymphatic hydrops. Int J Pediatr Otorhinolaryngol 1996;35:143–54. 10.1016/0165-5876(96)83899-7 - DOI - PubMed

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