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This case report describes the findings of a 45-year-old white woman from Brazil, who developed myalgia, fever and macular rash. She was diagnosed as having dengue, based on clinical manifestations and specific IgM titers. One week after the first symptoms of dengue, the patient developed muscle weakness, followed by tetraplegia with areflexia, and respiratory insufficiency. The electromyography had evidence of demyelinating neuropathy and the cerebrospinal fluid showed albuminocytologic dissociation. These neurologic findings were consistent with the diagnosis of Guillain-Barré syndrome. The patient was treated with immunoglobulin and metylprednisolone. Mechanical ventilation was started one week after hospital admission and maintained for four weeks. After six weeks of hospitalization the patient was discharged from the hospital on wheel chair, presenting mild muscle weakness and loss of patellar and ankle reflexes. When the patient was seen at the outpatient service three weeks after hospital discharge she was able to walk with help. This case report suggests a possible association between dengue and Guillain-Barré syndrome.

We reviewed 444 EEGs of 62 women with medically refractory epilepsy, followed up for at least 5 years and that had 5 or more EEGs. According to our definitions we found 18 patients (29%) with frequent seizures, 16 (25.8%) with very frequent seizures, 16 (25.8%) with controlled seizures and 12 (19.3%) with occasional seizures. Four patients (6.5%) always showed normal EEGs, 30 (48.4%) had normal and abnormal EEGs and 28 (45.2%) only abnormal EEGs. Among the patients who had only normal EEGs, two had all seizures controlled, one had occasional seizures and one had frequent seizures. Among the patients who had normal and abnormal EEGs, 10 had controlled seizures, 5 had occasional seizures, 9 had frequent seizures and 6 had very frequent seizures. In the group of patients with always abnormal EEGs, 4 had controlled seizures, 6 had occasional seizures, 8 had frequent seizures, and 10 had very frequent seizures. In relation to the last EEG, it was normal in 7 (43.7%) of 16 patients with controlled seizures, in 3 (25%) of 12 patients with occasional seizures and in 7 (38.9%) of 18 patients with frequent seizures, and in none of the patients with very frequent seizures. The patients who had only normal EEGs seem to have a better outcome than those with abnormal EEGs. We observed that the last EEG was normal in 43.7% of the patients with controlled seizures. These data may suggest a relative importance of the EEG considering the long-term prognosis regarding seizure control.