Genetic polymorphisms of the 5HT receptors are not related with depression in temporal lobe epilepsy caused by hippocampal sclerosis.

BACKGROUND: Temporal lobe epilepsy caused by hippocampal sclerosis (TLE-HS) is the most frequent form of drug-resistant epilepsy in adults. Mood disorders are the most frequent psychiatric comorbidities observed in these patients. Common pathophysiological mechanisms of epilepsy and psychiatric comorbidities include abnormalities in the serotonin pathway. The primary goal of this study was to determine the possible association between polymorphisms of genes encoding the serotonin receptors 5HT1A (rs6295), 5HT1B (rs6296), and 5HT2C (rs6318) and the presence of mood disorders in patients with TLE-HS. Our secondary goal was to evaluate the possible association between these variants and susceptibility to develop seizures in TLE-HS. METHODS: We assessed 119 patients with TLE-HS, with and without psychiatric comorbidities; 146 patients with major depressive disorder; and 113 healthy volunteers. Individuals were genotyped for the rs6295, rs6296, and rs6318 polymorphisms. RESULTS: No difference was observed between the group with TLE-HS, healthy controls, and the group with major depressive disorder without epilepsy regarding the polymorphisms that were evaluated. There was no correlation between rs6318, rs6295, rs6296, and epilepsy-related factors and history of psychiatric comorbidities. CONCLUSIONS: Our work suggests that the studied polymorphisms were not related to the presence of TLE, psychiatric comorbidities in TLE, and epilepsy-related factors.

Rivaroxaban for treatment of intraventricular thrombus in Chagas disease.

Chagas disease leads to congestive heart failure, apical aneurysm, and may cause stroke or systemic embolism for intraventricular thrombus. We present a case of a 61-year-old man admitted for stroke 5 months after a renal embolism. An intraventricular thrombus was observed, probably the source of the cerebral and renal embolisms. The patient refused warfarin and rivaroxaban was used instead. After 40 days of treatment the thrombus had dissolved, after 20 months of regular use of rivaroxaban no more embolic events were observed. The use of rivaroxaban was effective in preventing embolic events in Chagas disease and intraventricular thrombus. .

Malformação arteriovenosa dural do seio transverso-sigmóide causando neuralgia trigeminal / Transverse-sigmoid sinus dural arteriovenous malformation presenting as trigeminal neuralgia

Os autores relatam um caso raro de malformação arteriovenosa dural (MAVD) do seio transverso-sigmóide esquerdo, causando neuralgia do trigêmeo. O paciente foi submetido a cirurgia para esqueletização do seio transversosigmóide com ressecção dos dois terços distais do seio transverso e dos dois terços proximais do seio sigmóide. O procedimento cirúrgico foi suficiente para proporcionar a cura angiográfica e clínica, com um seguimento de oito meses. Foi realizada uma completa revisão bibliográfica encontrando-se apenas cinco casos descritos de pacientes com MAVD e neuralgia trigeminal.

The authors report a rare case of transverse-sigmoid dural arteriovenousmalformation (DAVM) presenting as trigeminal neuralgia in the distribution of left V3. The patient was treated surgically by the sinus skeletonization technique with the resection of the distal 2/3 of the transverse sinus and the proximal 2/3 of the sigmoid sinus. Clinical and angiographic cure was achieved in our patient with a folow-up of 8 months. Furthermore, a thorough review of the English language literature was carried out, compiling only five cases of trigeminal neuralgia due to DAVM.