The Brazilian doctor who has been at the forefront of the fight against Zika for the past year has weighed in on some of the potential birth defects.

Dr. Vanessa van der Linden, the physician who was one of the first researchers linking Zika to microcephaly—a birth defect where infants are born with smaller and misshapen heads—has expressed concerns over many of her patients she has observed in the last year.

Van der Linden, a pediatric neurologist at the Barão de Lucena Hospital, in Recife, Brazil, said in a Science News for Students article that while microcephaly remains the most common symptom, she has observed a number of other symptoms including muscle spasms, extreme irritability, difficulty swallowing and the possibility of crying for 24 hours straight.

Another issue van der Linden observed is a deformity called arthrogryposis, which can leave a child with contractures or joints stuck in contorted positions.  This disease has shown up in babies both with and without microcephaly.

Van der Linden described much of her findings and observations during a Sept. 22 workshop hosted by the National Institute of Health in North Bethesda, Md.

In the article, Peter Hotez, a pediatrician and microbiologist at Baylor College of Medicine in Houston, Texas, said some of the long-term impacts of Zika are still relatively unknown and symptoms including learning disabilities or developmental delays might emerge in the future.

Zika has become a growing concern in South America, the Caribbean and Florida.

Other symptoms observed include ear and eye problems in newborns.

In a Sept. 2 report from the U.S. Centers for Disease Control and Prevention (CDC), one in every 10 of the 70 Zika-exposed infants with microcephaly also experienced some hearing loss. Another study shows of 29 Brazilian babies observed with microcephaly more than one in every three had some eye oddity.

Other scientists have begun to study how Zika could impact the brain.

Marco Onorati, a scientist at Yale University, said in the article that he and colleagues found that the virus can invade and kill two different brain cells in neuroepithelial stem cells and radial glial cells.