Neurobrucellosis is caused by bacteria of the genus Brucella and is responsible for several clinical manifestations, making diagnosis challenging. The most common route of infection is through the consumption of unpasteurized or raw dairy products such as fresh milk, butter, and cheese. As neurological complications can develop chronically, they are frequently misdiagnosed as other infections, such as tuberculosis. This report reviews the clinical manifestations, diagnostic approach, treatment, and prognosis of neurobrucellosis, illustrating a case of chronic intracranial hypertension and meningoencephalitis secondary to brucellosis. The clinical presentation of brucellosis can mimic several systemic diseases, resulting in diagnostic delays and clinical complications. A high degree of suspicion is required, and neurobrucellosis should always be considered in the differential diagnosis of chronic meningitis.

Background Lacosamide (LCM) is a third-generation anti-seizure drug approved in Europe and the United States, either as a monotherapy or adjunctive therapy, to treat partial-onset seizures in adults, adolescents, and children. In Brazil, LCM is licensed for treatment only in patients older than 16 years of age. Objective To evaluate a cohort of children presenting with refractory epilepsy who received LCM as an add-on therapy and observe the response and tolerability to the LCM treatment. Methods A retrospective cohort study conducted in a tertiary health care facility, which included 26 children, aged up to 16 years, who presented with refractory epilepsy and received LCM as an add-on treatment. The follow-up visits were scheduled every 3 months until 9 months of treatment with LCM. Results After 3 months of LCM administration, in 73.1% of the children, there was a reduction of > 50% in the frequency of seizures, and this clinical improvement was maintained in most patients (73.9%) for the following 9 months. Mild (such as, somnolence and behavioral changes) or severe (seizure worsening) adverse effects were observed in two and three children respectively. Among responders to LCM, there was a higher prevalence of males, fewer concomitant anti-seizure drugs, and lower percentage of patients using sodium channel blockers. Conclusions Lacosamide should be considered as an early treatment option in pediatric patients with refractory epilepsy, mainly focal seizures.

Background: Epilepsy is highly comorbid with psychiatric disorders and a significant amount of the morbidity related to epilepsy is in fact a result of psychiatric comorbidities. Objective: To investigate the frequency of different psychiatric comorbidities in children with refractory epilepsy. Methods: We present preliminary observational data from a series of patients (n=82) examined in the psychiatric branch of a tertiary epilepsy center in Rio de Janeiro, Brazil. Patients were classified as presenting autism spectrum disorders, mood disorders, anxiety disorders, disruptive disorders, attention deficit hyperactivity disorder (ADHD), intellectual development disorder, psychotic episode, dissociative/conversive disorders or others. We determined the frequency of each disorder, along with demographic data, medications prescribed, electroencephalogram findings and additional medical examinations and consultations. Results: The most common comorbidities in our sample were autism spectrum disorders and ADHD. Antipsychotics and selective serotonin uptake inhibitors were the most commonly prescribed psychiatric medications. Conclusions: Knowledge about the prevalence of such comorbidities may provide more targeted interventions in Psychiatry and Psychology services linked to epilepsy centers.

Introduction: Studies have suggested beneficial effect of the continuous educational work in the prevention of chronic degenerative diseases. Objective: To describe the demographic, risk factors (RF) profile and knowledge of the participants of a Vascular Disease (VD) Prevention Campaign - Red September. Method: A cross-sectional descriptive analysis of data collected through a form with questions about RF associated with VD and the subject’s knowledgement about them. Results: In a total of 572 subjects (55% female), with a mean age of 43.7±16.4 years, the prevalence of RF for women and men respectively, was 29.1% x 28.3% for arterial hypertension (AH); 11.2% x 8.3% for diabetes mellitus; 15.5% x 13.3% for dyslipidemia; 55% x 65.1% for self-reports of anxiety and/or depression (A/D); 26.8% x 33.1% for family history of early VD and 7.6% x 6.7% of previous cardiovascular (CV) event. Dividing women by age group, the prevalence of AH, spontaneous report of A/D and insufficient physical activity found was, respectively, 5%, 36% and 63% for the group between 18-50 y/o; 50%, 52% and 65.5% for 51-70 y/o group, and 82.4%, 76.5% and 88.2% for women above 71 y/o. The participants' knowledge results reveal that 72% had a satisfactory answer on "what is an artery?", only 25% knew the doctor specialized in the care of VD, and 70.5% of the women and 84.4% of the men are unaware that fatigue may be a symptom. When questioned about which RFs are most related to VD, the first, second and third responses were, respectively: fatty diet (36.9%), inadequate diet (18.1 %) and sedentarism (19.3%). Despite of the knowledge of the causality of VD and CV presence, these RFs are significantly present in this population. Conclusion: The need for better strategies to reduce the discrepancy found in this sample is notorious, aimed at reducing the high percentage of modifiable RF that were evidenced in the analyzed population and have been already seen and published in previous studies.