Neurologically, the primary features seen most often and most evidently in infants were alterations in motor activity, reflected in body tone, posture and motility or movement;
severe hypertonia (abnormal muscle tension and contraction); abnormal neurobehaviors, such as poor or delayed response to visual stimuli, and excitability.
Although many of the components of this syndrome, such as cognitive, sensory, and motor disabilities, are shared by other congenital infections, 5 features differentiate CZS from other congenital infections: (1)
severe microcephaly with partially collapsed skull; (2) thin cerebral cortices with subcortical calcifications; (3) macular scarring and focal pigmentary retinal mottling; (4) congenital contractures; and (5) marked early
hypertonia with symptoms of extrapyramidal involvement (Table).