objectives: Discuss neuropsychiatric aspects and differential diagnosis of catatonic syndrome secondary to systemic lupus erythematosus (SLE) in a pediatric patient. Methods: Single case report. result: A 13-year-old male, after two months diagnosed with SLE, started to present psychotic symptoms (behavioral changes, hallucinations and delusions) that evolved into intense catatonia. During hospitalization, neuroimaging, biochemical and serological tests for differential diagnosis with metabolic encephalopathy, neurological tumors and neuroinfections, among other tests, were performed. The possibility of neuroleptic malignant syndrome, steroid-induced psychosis and catatonia was also evaluated. A complete reversal of catatonia was achieved after using benzodiazepines in high doses, associated with immunosuppressive therapy for lupus, which speaks in favor of catatonia secondary to autoimmune encephalitis due to lupus. conclusion: Although catatonia rarely is the initial clinical presentation of SLE, the delay in recognizing the syndrome can be risky, having a negative impact on prognosis. Benzodiazepines have an important role in the catatonia resolution, especially when associated with parallel specific organic base cause treatment. The use of neuroleptics should be avoided for the duration of the catatonic syndrome as it may cause clinical deterioration. resUMo objetivos: Discutir aspectos neuropsiquiátricos e o diagnóstico diferencial da síndrome catatônica secundária a lúpus eritematoso sistêmico (LES) em paciente pediátrico. Méto-dos: Relato de caso individual. resultado: Adolescente do sexo masculino com 13 anos de idade iniciou, após dois meses de diagnosticado com LES, quadro psicótico (alterações comportamentais, alucinações e delírios) que evoluiu para franca catatonia. Durante internação hospitalar foram realizados, entre outros, exames de neuroimagem, bioquímicos e sorologias para diagnóstico diferencial com encefalopatia metabólica, tumores neurológicos e neuroinfecções. Foi avaliada também a possibilidade de síndrome neuroléptica maligna, psicose e catatonia induzida por corticoides. Houve reversão completa da catatonia após o uso de benzodiazepínico em altas doses associado à terapia imunossupressora para o lúpus, o que fala a favor de uma catatonia secundária a uma encefalite autoimune de base lúpica.

Introduction. Guillain-Barré syndrome (GBS) can assume regional variations based on antecedent illness exposure, clinical manifestations, and prognosis. Nonetheless, evidence of GBS heterogeneity in Brazil is still lacking. Objective. To determine GBS characteristics including predisposing factors, diagnostic accuracy, risk of mechanical ventilation and compare the results with other regional and international epidemiological studies. Method. In this retrospective cross-sectional study, we conducted a documental search for patients treated for GBS. After the assessment of diagnostic reliability using Brighton Criteria, data were collected using medical record review by expert neurologists. We compared predicted risk for mechanical ventilation using the Erasmus GBS Respiratory Insufficiency Score (EGRIS) and patient observed outcome within the first week. Results. In all, 33 patients were included, with reasonable diagnostic accuracy in most patients (75%). 15.2% of patients required mechanical ventilation. There was a positive association (p=0.013) between non-high risk and the absence of need for mechanical ventilation. The most common immune trigger was gastroenteritis (30.3%), followed by upper airway infection (15.2%). Conclusions. This study provides the first evidence that EGRIS may be used to identify patients with low risk for mechanical ventilation in a Brazilian sample. Prospective cohort studies are needed to confirm this finding.  Clinical and epidemiological characteristics of patients are consistent with other Latin America observational studies, except on the predominance of gastroenteritis as a major immune trigger, as also observed in Brazilian Federal District, in Lima and Bangladesh.

Introduction. Alcohol withdrawal syndrome (AWS) can occur in about half of patients with alcohol use disorder who abruptly reduce or cease consumption of this substance. Epileptic seizures are one of the possible manifestations. Objective. Evaluate epidemiological data, clinical characteristics, length of hospital stay and recurrence of emergency medical care between patients with alcohol withdrawal-related epileptic seizures. Method. This is a retrospective observational study, with data collection from medical records of patients treated for epileptic seizures caused by AWS in a public hospital in Minas Gerais within a year. Inferential statistical association between nominal variables was assessed by cross-tabulation with the chi-square test. Results. 45 patients were included in the study. The most prevalent age group was 35 to 45 years (37.7%). In 46.6%, it was described a previous diagnosis of epilepsy. There was an association between the previous diagnosis of epilepsy and the presence of epileptic seizures (p<0.001). The type of seizure was generalized tonic-clonic since the onset in 92% of cases. 78% had seizures up to 48 hours after the last alcohol consumption. The rate of recurrence at the emergency department during the year was 31%. Conclusion. AWS-related epileptic seizures predominantly affect young men and are associated with a high recurrence rate of need of emergency hospital care, being a complex public health problem. These data point to the need to strengthen strategies for primary prevention.