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Background: Stroke is one of the main causes of death and disability. It leaves sequels in the capacity for attention, language, memory, spatial, behavioral vision, and in all other cognitive domains. Therefore, it is essential to optimize neuropsychological rehabilitation in patients with stroke. The earlier the interventions, the greater the chances of adapting and minimizing the acquired sequelae. Objectives: We aim to map and review publications on neuropsychological rehabilitation in stroke patients. We also seek to identify the sequelae described in the literature in this regard, as well as the types of interventions made. Methods: This is a systematic review of the literature, carried out using the PubMed and Capes platforms. We use the descriptors “stroke” and “neuropsychology”. The filters were: descriptors in the title and / or summary in the last 5 years (PubMed) and 1 in the last year (Capes). Results: We found 28 articles of which 10 were disregarded, as they did not fit the established criteria. Conclusions: There was an absence of representativeness outside the English language, which undermines the global and local understanding of the topic. In addition, there is a need to adapt the instruments used in neuropsychological rehabilitation considering the needs of stroke victims, encompassing the various existing factors, in order to promote the patient’s better quality of life. Finally, it must be taken into account that the sequelae must be worked on also thinking about their neural associations and other domains.

To describe epilepsy after congenital Zika virus infection (ZIKV) and its relationship with structural neuroimaging findings.This was a cross-sectional study in children (aged 13-42 months) who were born with microcephaly due to ZIKV infection between 2015-2017. Patients underwent a brain imaging scan (magnetic resonance) and a video-EEG study.Among the patients (n = 43), 55.8 % were male, 88.4 % were born at term, mean head circumference at the birth was 29.7 ± 1.8 cm, and 44.8 % were infected in the first trimester of pregnancy. Neuroimaging was moderately abnormal in 30.2 % and severely abnormal in 46.5 % of patients. Early seizures (6 months of age) were observed in 41.9 %. EEG background was abnormal when asleep or awake in 72.1 % and during sleep in 62.8 %. The interictal epileptogenic activity was recorded on 41/43 of the EEGs and was predominantly multifocal (62.8 %). An ictal EEG was obtained in 22 patients and 31.8 % had more than one seizure type. Sleep EEG (background) patterns, interictal epileptogenic activity (p = 0.046), interictal discharge localization (p = 0.015), type of ictal epileptogenic activity (p = 0.002), and localization of ictal discharge (p = 0.024) were significantly different between neuroimaging groups. The mild neuroimaging group had a higher chance of having more frequently normal sleep EEG patterns, no interictal epileptogenic activity and a further increase in the probability of walking without limitations, and less neurodevelopment delay.In patients with congenital Zika virus syndrome, epilepsy tended to be early and refractory. EEG features correlated with degree of neuroimaging abnormalities.

Paroxysmal abnormalities of motor or non-motor function are defined as epileptic when they co-occur with specific patterns of organized electrical activity as measured by scalp electroencephalography (EEG). Certain forms of abdominal pain and migraine may be therefore epileptic [1]. Stereotypical movements at night can be the result of mesial frontal epilepsy, despite a negative EEG and prolonged focal paroxysmal dystonia can result from unilateral putaminal hemorrhage [2]. Short-lasting motor activity categorized clinically as dystonia or athetosis, meeting criteria for paroxysmal non-kinesigenic dyskinesia (PNKD), may result from caudate nucleus rather than cortical discharges [3,4]. These examples suggest that epileptic activity affecting different neural networks may manifest unique motor and non-motor clinical phenotypes, beyond the classic myoclonic or tonic-clonic motor phenomena attributed to cortical epilepsy. To this end, using video-EEG, we documented ictal discharges in the left temporal lobe of a patient with episodic chorea, initially suspected to be within the PNKD spectrum, suggesting that paroxysmal chorea can also be of epileptic origin in a subtype of patients. Fil: Gameleira, Fernando Tenório. Universidade Federal de Alagoas; Brasil Fil: Alúcio, Karina Torres. Universidade Federal de Alagoas; Brasil Fil: de Paiva, Maria Luísa Maia Nobre. Universidade Federal de Alagoas; Brasil Fil: de Lima Carlos, Kathleen Caroline. Universidade Federal de Alagoas; Brasil Fil: de Lima, Kedma Mayara. Universidade Federal de Alagoas; Brasil Fil: Gameleira, Mariana Holanda. Universidade Federal de Alagoas; Brasil Fil: Kauffman, Marcelo Andres. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina Fil: Espay, Alberto J.. University of Cincinnati; Estados Unidos

Juvenile myoclonic epilepsy (JME) accounts for 26% of generalized idiopathic epileptic syndromes. The highest levels of thrombin activity are closely involved in the development of neurological diseases, including epilepsy. The prothrombin c.20210G>A (rs1799963) variation, which alters prothrombin mRNA stability, is associated with high plasma prothrombin levels. Objective : The present study was designed to investigate whether the SNP rs1799963 is a risk factor for JME in the northeastern Brazilian population. Results : The polymorphism was genotyped in 207 controls and 123 patients using polymerase chain reaction-restriction fragment length polymorphism method. No significant differences were observed in the genotype and allele frequencies of this polymorphism between cases and controls. Conclusion : These results present no evidence for an association of rs1799963 with JME. Further studies including other types of epilepsy are required to investigate the involvement of prothrombin gene in the genetic susceptibility to chronic seizure. Epilepsia mioclônica juvenil (EMJ) representa 26% das síndromes epilépticas idiopáticas generalizadas. Níveis elevados de atividade da trombina estão intimamente envolvidos no desenvolvimento de distúrbios neurológicos, incluindo epilepsia. A variante c.20210G>A (rs1799963) do gene de protrombina, que altera a estabilidade do RNAm, está associada com altos níveis de protrombina no plasma. Objetivo: Investigar se o SNP rs1799963 é um fator de risco para EMJ em uma amostra da população do nordeste brasileiro. Resultados : O polimorfismo foi genotipado em 123 pacientes e 207 controles usando a reação de polimerase em cadeia com restrição de polimorfismo. Não observamos diferença significativa nas frequências alélicas e genotípicas deste polimorfismo, entre as populações de pacientes e controle. Conclusão : Estes resultados não demonstram evidências para uma associação do polimorfismo rs1799963 com EMJ. Estudos posteriores, incluindo outros tipos de epilepsia, são necessários para investigar o envolvimento do gene protrombina na susceptibilidade genética a crises crônicas.

OBJECTIVE: To describe developmental characteristics, morphological aspects and incidence of temporal sharp transients (TST) in normal preterm and term newborns at matched conceptional ages (CA). METHOD: Neonatal EEGs from two groups of normal newborns were evaluated in order to identify and characterize TST. Group I (n=40) consisted of newborns from 34 to 40 weeks of gestational age (GA) that were submitted to a single EEG between 24 and 48 hours of life. Group II consisted of 10 preterm newborns with GA between 30-32 weeks, followed with a weekly EEG until they reached term. Morphology of TST was divided in 3 groups (temporal sawtooth, isolated transients or repetitive transients). TST index, density and total number were calculated in each polysomnography and related to sleep stages and CA. Laterality (right/left) was also evaluated. The groups were compared at 34, 36, 38 and 40 weeks of CA. RESULTS: TST index and density decreased with the increase of CA in both groups (p

Sleep disturbance is common in several epilepsy types, such as juvenile myoclonic epilepsy (JME). Genetic background could increase susceptibility to seizure and sleep abnormalities. From this perspective, a susceptibility gene for sleep disturbance or chronotype could contribute to the genetic susceptibility threshold for epilepsy and vice versa. Accordingly, we investigated whether functional clock gene polymorphisms (PER2 111C>G, CLOCK 3111T>C, and PER3 VNTR) might influence the risk for JME. All these polymorphisms have recently been reported to be associated with sleep disturbance, diurnal variation, and neurological diseases. The polymorphisms were genotyped in 97 patients and 212 controls using polymerase chain reaction or restriction fragment length polymorphism methods. No significant differences were observed in the genotypic and allelic frequencies of these polymorphisms between cases and controls even when analyses were restricted to patients that presented a diurnal preferential seizure occurrence. We also tested for interactions between polymorphisms by multifactor dimensionality reduction analysis. None of the combined genotypes differed significantly between the groups. These results present no evidence for an association of these polymorphisms with JME. Further studies including other types of epilepsy and/or other functional polymorphisms are required to investigate the possible relationship between clock genes and the genetic susceptibility to chronic seizure.

Background: Juvenile myoclonic epilepsy (JME) is an idiopathic generalized epilepsy syndrome with genetic basis and accounts for 10% of all forms of epilepsy. Despite the existence of rare mutations responsible for some familial forms inherited in a Mendelian pattern, the genetics of JME is complex and probably involves multiple genes. Because of widespread distribution in the central nervous system (CNS) and their ability to produce postsynaptic inhibition, GABA (A) receptor subunits (GABRs) encoding genes represent high ranking candidates for epilepsy susceptibility. Aim: This case/control study was designed to investigate whether the rs211037 of the GABRG2 gene is a risk factor for JME in the Brazilian population. Materials and Methods: The polymorphism was genotyped in 98 patients and 130 controls using polymerase chain reaction-restriction fragment length polymorphism method. Descriptive and statistical analyses were performed using SNP stat software. Results: Genotype proportions and allele frequencies for the rs211037 polymorphism of the GABARG2 gene did not differ significantly between the groups, even when the odds ratio was adjusted for clinical variables. Conclusion: These results present no evidence for an association of rs211037 with JME. Further studies are required to investigate the involvement of the GABRG2 gene in the genetic susceptibility to this epileptic syndrome.

INTRODUÇÃO: A Epilepsia Mioclônica Juvenil (EMJ) é uma epilepsia idiopática generalizada, que, apesar de descrita há mais de um século, é uma entidade clínica ainda subdiagnosticada. OBJETIVO: Apresentar o perfil clínico, epidemiológico e terapêutico de pacientes com EMJ, além de mensurar a qualidade de vida destes. METODOLOGIA: Foram avaliados dezenove pacientes com EMJ, acompanhados no Hospital Universitário da Universidade Federal de Alagoas, com o Protocolo de Consulta Clínica e o QOLIE-31 (Quality of life in epilepsy), versão brasileira. RESULTADOS: O estudo mostrou que dentre os 19 pacientes selecionados, 12 (63%) eram do sexo feminino; a idade de início das crises epiléticas teve média de 12 anos (±3); a história familiar para epilepsia foi positiva 78,9% dos entrevistados; todos apresentavam crises mioclônicas de predomínio matinal associadas a crises tônico-clônicas generalizadas; 14 pacientes (73,7%) estavam em monoterapia, sendo 13 com o ácido valpróico. A "Pontuação Global" (Overall score) do QOLIE-31 variou de 26 a 98, com média de 62,1 (±18,4) e T-score (escore padronizado) corresponde a 47. CONCLUSÃO: A análise dos resultados auxilia sobremaneira na melhor caracterização deste grupo de pacientes, além de quantificar através de instrumento validado, pela primeira vez, a qualidade de vida destes, a qual não pode mais ser ignorada no seu manejo.