Cannabidiol (CBD) is a component of Cannabis sativa that has a broad spectrum of potential therapeutic effects in neuropsychiatric and other disorders. However, few studies have investigated the possible interference of CBD on the sleep-wake cycle. The aim of the present study was to evaluate the effect of a clinically anxiolytic dose of CBD on the sleep-wake cycle of healthy subjects in a crossover, double-blind design. Twenty-seven healthy volunteers that fulfilled the eligibility criteria were selected and allocated to receive either CBD (300 mg) or placebo in the first night in a double-blind randomized design (one volunteer withdrew from the study). In the second night, the same procedure was performed using the substance that had not been administered in the previous occasion. CBD or placebo were administered 30 min before the start of polysomnography recordings that lasted 8 h. Cognitive and subjective measures were performed immediately after polysomnography to assess possible residual effects of CBD. The drug did not induce any significant effect (p > 0.05). Different from anxiolytic and antidepressant drugs such as benzodiazepines and selective serotonin reuptake inhibitors, acute administration of an anxiolytic dose of CBD does not seem to interfere with the sleep cycle of healthy volunteers. The present findings support the proposal that CBD do not alter normal sleep architecture. Future studies should address the effects of CBD on the sleep-wake cycle of patient populations as well as in clinical trials with larger samples and chronic use of different doses of CBD. Such studies are desirable and opportune.

Animal studies and preliminary clinical trials have shown that cannabidiol (CBD)-enriched extracts may have beneficial effects for children with treatment-resistant epilepsy. However, these compounds are not yet registered as medicines by regulatory agencies. We describe the cases of two children with treatment-resistant epilepsy (Case A with left frontal dysplasia and Case B with Dravet Syndrome) with initial symptom improvement after the introduction of CBD extracts followed by seizure worsening after a short time. The children presented typical signs of intoxication by Δ9-THC (inappropriate laughter, ataxia, reduced attention, and eye redness) after using a CBD-enriched extract. The extract was replaced by the same dose of purified CBD with no Δ9-THC in both cases, which led to improvement in intoxication signs and seizure remission. These cases support pre-clinical and preliminary clinical evidence suggesting that CBD may be effective for some patients with epilepsy. Moreover, the cases highlight the need for randomized clinical trials using high-quality and reliable substances to ascertain the safety and efficacy of cannabinoids as medicines.

-Menkes' disease is a rare neurodegenerative disorder due to an intracellular defect of a copper transport protein. We describe a 7 months male patient who presented with seizures, hypoactivity and absence of visual contact. The investigation disclosed pilli torti and thrycorrexis nodosa in the hair, low serum levels of both copper and ceruloplasmin, brain magnetic resonance study showed atrophy and white matter hypointensities on T1-weighted images, electroencephalogram reveals moderate background activity disorganization and epileptiform activity, and muscle biopsy with type 2 fiber atrophy. The clinical, laboratorial, genetic, muscle biopsy and neurophysiological findings in Menkes' disease are discussed.KEY WORDS: Menkes' disease, copper, ceruloplasmin. Doença de Menkes: relato de casoRESUMO -A doença de Menkes é uma rara desordem neurodegenerativa causada por defeito intracelular na proteína transportadora do cobre. Descrevemos um paciente de 7 meses, masculino, com crises convulsivas, hipoatividade e ausência de contato visual. A investigação demonstrou pilli torti e thrycorrexis

PurposeThe present study reports a case of encephalitis due to herpes simplex virus-1 (HSV-1), following surgical manipulation of the site of a primary infection.MethodsHerpes simplex virus-1 infection was confirmed by CSF PCR and DNA sequencing.ResultsThe patient was an 11-year-old girl who required temporal lobe surgery for epilepsy. She had meningoencephalitis due to HSV at the age of 20 months, and she was treated with acyclovir. Three years later, the patient developed uncontrolled seizures that became more frequent and changed in character at 11 years of age. On the 12th postoperative day, she developed fever and seizures, and she was diagnosed with HSV-1 by positive CSF PCR. She was treated with acyclovir (30 mg/kg/day for 21 days). In this report, we describe the patient and review the relevant literature.ConclusionThe authors stress the potential risk of reactivation of HSV encephalitis after intracranial surgery. Herpes simplex virus encephalitis must be considered in neurosurgical patients who develop postoperative seizures and fever.

Filmes plásticos flexíveis multicamadas podem ser utilizados como embalagens termoformadas de produtos alimentícios à base de carne, sendo que para esta aplicação, necessitam apresentar especificações técnicas de média ou alta barreira ao oxigênio, dependendo das características do produto a ser embalado, de forma a evitar sua contaminação e risco à saúde humana durante seu tempo-de-prateleira. No entanto, o processo de termoformação altera as características dos filmes planos originais. O processamento pode fazê-los não mais atender às especificações exigidas, principalmente nos cantos das embalagens, que são os pontos críticos. Neste trabalho, foram avaliados os efeitos da termoformação em propriedades de filmes plásticos multicamadas denominados de média barreira, compostos de PP/Adesivo/PA6/Adesivo/ PA6/Adesivo/PEBD, e de alta barreira, onde a camada intermediária de adesivo foi substituída por uma camada de copolímero de etileno-álcool vinílico (EVOH). A caracterização dos filmes incluiu investigações de espessura e taxa de permeabilidade ao oxigênio, além das propriedades mecânicas e óticas.

The aim of the study was to analyze a series of Brazilian patients with Niemann-Pick disease type C (NP-C). Method: Correlations between clinical findings, laboratory data, molecular findings and treatment response are presented. Result: The sample consisted of 5 patients aged 8 to 26 years. Vertical supranuclear gaze palsy, cerebellar ataxia, dementia, dystonia and dysarthria were present in all cases. Filipin staining showed the "classical" pattern in two patients and a "variant" pattern in three patients. Molecular analysis found mutations in the NPC1 gene in all alleles. Miglustat treatment was administered to 4 patients. Conclusion: Although filipin staining should be used to confirm the diagnosis, bone marrow sea-blue histiocytes often help to diagnosis of NP-C. The p.P1007A mutation seems to be correlated with the "variant" pattern in filipin staining. Miglustat treatment response seems to be correlated with the age at disease onset and disability scale score at diagnosis.Keywords: Niemann-Pick disease type C, bone marrow, filipin stain, NPC1gene, miglustat.RESUMO O objetivo desse estudo foi analisar uma série de casos de pacientes brasileiros com doença de Niemann-Pick tipo C (NP-C). Método: Correlação entre manifestações clínicas, alterações laboratoriais, estudo molecular e resposta ao tratamento foram realizadas. Resultado: A amostra consiste de 5 pacientes com idade entre 8 e 26 anos. Paralisia do olhar vertical supranuclear, ataxia cerebelar, demência, distonia e disartria estavam presentes em todos os casos. Coloração de filipina na cultura de fibroblastos mostrou padrão "clássico" em dois pacientes e padrão "variante" em três casos. O estudo molecular encontrou mutações no gene NPC1 em todos os alelos. O tratamento com miglustate foi realizado em 4 pacientes. Conclusão: Embora coloração de filipina seja utilizada para confirmar o diagnóstico, o histiócito azul-marinho no aspirado de medula óssea frequentemente auxilia a confirmar o diagnóstico de NP-C. A mutação p.P1007A está correlacionada com o padrão " variante" na coloração de filipina. A resposta ao tratamento com miglustate parece estar correlacionada com a idade e escore de desabilidade no momento do diagnóstico.Palavras-chave: doença de Niemann-Pick tipo C, medula óssea, coloração de filipina, gene NPC1, miglustate.Niemann-Pick disease type C (NP-C) is a rare inherited disease, caused by mutations in either the NPC1 or the NPC2 gene, which leads to impaired intracellular lipid trafficking and the accumulation of cholesterol and glycosphingolipids in the brain and other tissues [1][2][3][4][5][6] . The clinical signs and symptoms of NP-C can develop at any age, and significant phenotypic heterogeneity is frequently observed in NP-C 1,2,4-7 . Vertical supranuclear gaze palsy, cerebellar ataxia, dystonia, dementia, epilepsy and visceral manifestations are the most common symptoms of NP-C 1,2,4-7 .NP-C patients often show sea-blue histiocytes or foamy cells in bone marrow analyses and intracellular lipid accumulation with filipin stain...

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A 5-year-old female, with abnormal facial features, strabismus, horizontal nystagmus, hypotonia, and a history of hypersomnolence, seizures and developmental delay, began to present a generalized complex movement disorder. Clinically, there was a mixed hyperkinetic movement disorder, consisting of chorea, dystonia, myoclonus, and hand stereotypies. The presence of generalized jerks, interposed with those complex movements, resembled a "stop-motion" animation (Video 1), similar to the animation technique, in which objects are physically manipulated in small