Author(s)
Alexander Cherches, MD
Avani Vasireddy, BA
Celia Mizelle, MD
Monica Ogunsusi, MD
Kristal Riska, PhD
Eileen Raynor, MD
Affiliation(s)
University of Colorado
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand the significance of vestibular sequelae and gross motor delay in patients with congenital cytomegalovirus.
Objectives: cCMV is the leading cause of neurodevelopmental delay and nongenetic hearing loss in children. Despite the close relationship between auditory and vestibular organs, there is a lack of literature and recommended management regarding the vestibular sequelae of cCMV. We will describe presence of vestibular symptoms, motor delays, and referral status for infants with cCMV at two major centers.
Study Design: Qualitative analysis using retrospective chart review.
Methods: 69 patients were identified with positive CMV testing within the first 21 days of life between 2014 to 2022 at two major academic health systems. Retrospective chart review was performed to identify rates and types of motor delay, vestibular dysfunction findings, antiviral therapy, diagnosis of hearing loss, and referrals to vestibular therapy.
Results: 11 (15.7% of 69) patients had evidence of vestibular dysfunction and 27 (39.1% of 69) were found to have gross motor delays. There were 50 (72.5%) patients who were symptomatic at birth. All 11 with vestibular dysfunction were symptomatic at birth, along with 24 of those with motor delays. For those asymptomatic at birth, none were found to have vestibular dysfunction, but 3 (18.8% of 16) ultimately developed gross motor delay. None of the patients were referred to vestibular therapy.
Conclusions: This study's findings suggest that vestibular dysfunction may be underdiagnosed, under-referred, and ultimately undertreated. Although vestibular assessments may be challenging in pediatric patients, the potential to improve vestibular and motor function suggests that establishing care with vestibular rehabilitation is warranted for infants with cCMV.