Herpes encephalitis : clinical, laboratory and early electroencephalographic findings in a pediatric population receiving care at Hospital de Clínicas de Porto Alegre

OBJETIVO: Descrever a experiência do Setor de Neurologia Pediátrica do Hospital de Clínicas de Porto Alegre com o diagnóstico e o tratamento da encefalite herpética. MÉTODOS: Foram revisados os registros médicos de todos os pacientes de 0 a 12 anos tratados no Hospital com diagnóstico de encefalite herpética de janeiro de 1998 a janeiro de 2001. RESULTADOS: Dos sete pacientes identificados, seis eram de cor branca e quatro eram do sexo masculino. A média de idade foi de 20,6 meses. O achado clínico mais freqüente foi febre, seguido por alteração da consciência, sintomas gripais, lesões orais, convulsão e irritabilidade. Todos tiveram EEG alterado com paroxismos localizados no hemisfério esquerdo. Em seis pacientes havia lentificação e localização temporal. Cinco pacientes realizaram tomografia computadorizada de crânio, que revelou alterações em quatro casos. Os achados no líquido cefalorraquidiano foram do tipo encefalite linfomonocitária. Quanto ao tratamento, todos os pacientes fizeram cursos de 21 dias de aciclovir. Não registramos óbitos. CONCLUSÕES: Nossos achados assemelham-se aos da literatura. Diferentemente de outros trabalhos, encontramos um predomínio de ocorrência da encefalite herpética entre os meses de novembro e janeiro — seis de sete casos, sendo quatro em janeiro.OBJECTIVE: To describe the experience of the Pediatric Neurology Sector at Hospital de Clínicas de Porto Alegre, Brazil, with the diagnosis and treatment of herpes encephalitis. METHODS: Review of medical records of all patients between 0 and 12 years of age receiving care at the Hospital with a diagnosis of herpes encephalitis between January of 1998 and January of 2001. RESULTS: Seven patients were identified (six were white, four were male). Mean age was 20.6 months. The most frequent clinical finding was fever, followed by deterioration of consciousness level, flu-like symptoms, oral lesions, seizures and irritability. All patients had altered electroencephalographic results with paroxysm over the left hemisphere. In six patients there was slow activity and temporal localization. Computed tomography was performed in five patients. Pathologic findings were present in four cases. The analysis of cerebrospinal fluid revealed features resembling lymphomonocytic encephalitis. All patients used acyclovir during 21 days. There were no deaths. RESULTS: Our findings are similar to those reported in the literature. Differently from other studies, we observed a predominance of cases of herpes encephalitis between November and January – six cases out of seven, four being in January

Herpes encephalitis : clinical, laboratory and early electroencephalographic findings in a pediatric population receiving care at Hospital de Clínicas de Porto Alegre

OBJETIVO: Descrever a experiência do Setor de Neurologia Pediátrica do Hospital de Clínicas de Porto Alegre com o diagnóstico e o tratamento da encefalite herpética. MÉTODOS: Foram revisados os registros médicos de todos os pacientes de 0 a 12 anos tratados no Hospital com diagnóstico de encefalite herpética de janeiro de 1998 a janeiro de 2001. RESULTADOS: Dos sete pacientes identificados, seis eram de cor branca e quatro eram do sexo masculino. A média de idade foi de 20,6 meses. O achado clínico mais freqüente foi febre, seguido por alteração da consciência, sintomas gripais, lesões orais, convulsão e irritabilidade. Todos tiveram EEG alterado com paroxismos localizados no hemisfério esquerdo. Em seis pacientes havia lentificação e localização temporal. Cinco pacientes realizaram tomografia computadorizada de crânio, que revelou alterações em quatro casos. Os achados no líquido cefalorraquidiano foram do tipo encefalite linfomonocitária. Quanto ao tratamento, todos os pacientes fizeram cursos de 21 dias de aciclovir. Não registramos óbitos. CONCLUSÕES: Nossos achados assemelham-se aos da literatura. Diferentemente de outros trabalhos, encontramos um predomínio de ocorrência da encefalite herpética entre os meses de novembro e janeiro — seis de sete casos, sendo quatro em janeiro.OBJECTIVE: To describe the experience of the Pediatric Neurology Sector at Hospital de Clínicas de Porto Alegre, Brazil, with the diagnosis and treatment of herpes encephalitis. METHODS: Review of medical records of all patients between 0 and 12 years of age receiving care at the Hospital with a diagnosis of herpes encephalitis between January of 1998 and January of 2001. RESULTS: Seven patients were identified (six were white, four were male). Mean age was 20.6 months. The most frequent clinical finding was fever, followed by deterioration of consciousness level, flu-like symptoms, oral lesions, seizures and irritability. All patients had altered electroencephalographic results with paroxysm over the left hemisphere. In six patients there was slow activity and temporal localization. Computed tomography was performed in five patients. Pathologic findings were present in four cases. The analysis of cerebrospinal fluid revealed features resembling lymphomonocytic encephalitis. All patients used acyclovir during 21 days. There were no deaths. RESULTS: Our findings are similar to those reported in the literature. Differently from other studies, we observed a predominance of cases of herpes encephalitis between November and January – six cases out of seven, four being in January

In vivo and in vitro effect of imipramine and fluoxetine on Na+, K+-ATPase activity in synaptic plasma membranes from the cerebral cortex of rats

The effects of in vivo chronic treatment and in vitro addition of imipramine, a tricyclic antidepressant, or fluoxetine, a selective serotonin reuptake inhibitor, on the cortical membrane-bound Na+,K+- ATPase activity were studied. Adult Wistar rats received daily intraperitoneal injections of 10 mg/kg of imipramine or fluoxetine for 14 days. Twelve hours after the last injection rats were decapitated and synaptic plasma membranes (SPM) from cerebral cortex were prepared to determine Na+,K+-ATPase activity. There was a significant decrease (10%) in enzyme activity after imipramine but fluoxetine treatment caused a significant increase (27%) in Na+,K+-ATPase activity compared to control (P<0.05, ANOVA; N = 7 for each group). When assayed in vitro, the addition of both drugs to SPM of naive rats caused a dose-dependent decrease in enzyme activity, with the maximal inhibition (60-80%) occurring at 0.5 mM. We suggest that a) imipramine might decrease Na+,K+-ATPase activity by altering membrane fluidity, as previously proposed, and b) stimulation of this enzyme might contribute to the therapeutic efficacy of fluoxetine, since brain Na+,K+-ATPase activity is decreased in bipolar patients

Glutationa previne a redução da atividade da Na+,K+-ATPase causada pelo ácido metilmalônico em córtex cerebral de ratos

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Efeito da administração aguda e crônica de ácido metilmalônico sobre a atividade da Na+, K+ - ATPase em córtex cerebral de ratos

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Efeito da administração aguda e crônica de ácido metilmalônico sobre a atividade da Na+, K+ - ATPase em córtex cerebral de ratos

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Glutationa previne a redução da atividade da Na+,K+-ATPase causada pelo ácido metilmalônico em córtex cerebral de ratos

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Administração da fluoxetina estimula a atividade da Na+, K+ - ATPase de córtex cerebral de ratos

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Efeito do metilmalonato sobre a atividade da Na+, K+- ATPase de córtex cerebral de ratos

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Efeito da administração crônica de imipramina sobre a atividade da Na+, K+ ATPase cerebral de ratos

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