Childhood microcephaly: clinical and developmental repercussions: an integrative review

Abstract

Introduction: Microcephaly is characterized by reduced head circumference and can be associated with various etiological conditions, including congenital infections, genetic abnormalities, and other factors that impact child development. Its manifestations may involve neurological, motor, and functional aspects, necessitating longitudinal, multidisciplinary follow-up. In this context, physical therapy can contribute to early stimulation and the monitoring of these children's motor and functional skills. Objective: To analyze, through an integrative literature review, the repercussions of microcephaly on child development, with an emphasis on the clinical manifestations and alterations in neuropsychomotor development described in the literature. Methods: This is an integrative literature review with a descriptive nature and qualitative approach, conducted according to the stages proposed by Whittemore and Knafl, and by Mendes, Silveira, and Galvão. Searches were performed in the PubMed/MEDLINE, SciELO, and Virtual Health Library (VHL) databases using descriptors related to microcephaly, child development, early stimulation, and physical therapy, combined using the Boolean operators AND and OR. Studies involving children with microcephaly—regardless of etiology—published according to established eligibility criteria were considered. The search was conducted in September 2026. The synthesis of findings was organized into three thematic areas: clinical characteristics and manifestations of microcephaly; impacts on child development; and early stimulation and the contributions of physical therapy. Results: Three studies were included: one retrospective cross-sectional study and two systematic reviews. The findings highlighted various aspects of childhood microcephaly, covering diagnostic criteria, potential etiologies, and associated manifestations. Bertozzi et al. emphasized the importance of using appropriate anthropometric parameters for diagnosing microcephaly and identified various potential etiologies among the analyzed cases. Quintans, Bueno, and Cardoso demonstrated that different infectious agents can be linked to microcephaly associated with congenital infections, showing that its infectious etiology is not limited to the Zika virus. Santos et al. identified sleep-related neurophysiological repercussions in children with Zika-associated microcephaly, including alterations in brain activity during sleep and the occurrence of epileptogenic activity. Thus, the synthesized evidence focused predominantly on the diagnostic, etiological, and neurophysiological aspects of microcephaly. Conclusion: The included studies demonstrated that microcephaly exhibits heterogeneity regarding diagnostic criteria and potential etiologies; furthermore, it is associated with neurological and neurophysiological manifestations—particularly alterations in brain activity during sleep in children with Zika-associated microcephaly. Given the scope of the identified evidence, it was not possible to draw specific conclusions regarding repercussions on neuropsychomotor development or the effectiveness and contributions of physical therapy interventions. Considerations regarding early stimulation and the role of physical therapy are based on supplementary literature and should be understood as theoretical context rather than results derived from the studies included in the sample. There is a need for primary, longitudinal studies that directly investigate child development and the effects of physical therapy interventions in children with microcephaly.