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Samples of ventricular CSF were taken from 52 consecutive patients admitted for psychosurgery for intractable depression. Concentrations of asparagine, aspartate, glutamine, glutamic acid, and serine were determined. Glutamate and aspartate concentrations, implicated in excitotoxic brain damage, were not affected by various types of psychotropic drug treatment. Serine, a modulator of glutamate responses, was significantly elevated in samples from subjects receiving antidepressants. These subjects responded poorly to the operation. Psychotropic drugs are unlikely to be neurotoxic. Nevertheless, antidepressants may influence excitatory neurotransmission.

A 45 years-old woman presented with loss of initiative and memory, motivated cry and behaviour disturbance with childish traits, quickly progressive along 6 months until total apathy. An EEG showed periodic activity with bilateral triphasic waves against a flattened background activity suggesting Creutzfeldt-Jacob disease (CJD), but investigation for treatable causes of dementia disclosed hypercalcemia and hypophosphatemia. Further investigation showed a mass at the thyroid region that at surgery was identified as an oxyphilic cells adenoma. With electrolyte disturbance correction and posterior surgery there was normalization of both EEG and clinical status. Though it was previously reported mental confusion and EEG alteration associated with hyperparathyroidism we do not know of any previous case of confusion associated with periodic activity in EEG as in this disease. Hyperparathyroidism should be a differential diagnosis in every "de novo" case of CJD.

A investigation was done on EEG evolution of 9 patients with PLEDs. In all patients PLEDs eventually disappeared, in general in a short period, less than 4 days in 5 cases. In 4 cases evolution was to slow background activity, and to posterior normalization in 2. In 3 cases evolution was to delta activity and suppression bursts, and all the 3 patients died. In the last 2 patients PLEDs were replaced by localized paroxysmal activity, which was anteriorly registered in 1. PLEDs was found in acute dysfunction of CNS, and in epileptic patients in periods of increased seizure activity. These data suggest that a critical point of alteration of the normal neuronal activity is needed for appearance and maintenance of PLEDs. No correlation could be done between the evolution of PLEDs, always to disappearance, and clinical outcome, that was variable.

Alzheimer disease (AD) is a progressive and irreversible neurodegenerative disorder that is characterized by cognitive decline, memory loss and confusion. The E4 allele of the apolipoprotein E gene (APOE) is associated with AD and it is the main genetic risk factor for disease. Although the exact physiological function is unknown, bleomycin hydrolase (BLMH) may also be associated with AD development, although previous immunohistochemical findings have been inconsistent. Therefore, the purpose of this study was to evaluate the genotypic and allele frequencies of the APOE gene and BLMH 1450 G > A polymorphism and assess BLMH expression using PCR-RFLP and RT-qPCR analyses of blood samples from patients with Alzheimer disease (AD), healthy elderly adults (EC) and healthy young subjects (YC). BLMH expression was significantly different among groups (p = 0.015) and there was substantial reduction with age and with AD. The APOE and BLMH genotype frequency did not diverge from the Hardy-Weinberg equilibrium. There was a higher frequency of genotype 3/3 in all subjects (61.1%) and the AD group demonstrated a higher frequency of allele 4; however, differences in genotype and allele distributions were statistically different among groups.

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