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Objective: To identify current evidence on the use of topiramate for refractory status epilepticus. Methods: We reviewed the literature to investigate the efficacy of topiramate in the treatment of refractory status epilepticus. The search terms used were "status epilepticus", "refractory", "treatment" and "topiramate". No restrictions were used. Results: The search yielded 487 articles that reported using topiramate as a treatment for refractory status epilepticus and its outcomes. Case reports, review articles, and animal experiments were excluded. After excluding duplicates and applying inclusion and exclusion criteria, nine studies were included for analyses. Descriptive and qualitative analyses were performed, and the results were as follows: response rates (defined as termination in-hospital until 72 hours after the administration of topiramate) varied from 27% to 100%. The mortality rate varied from 5.9% to 68%. Positive functional long-term outcomes, defined as discharge, back to baseline or rehabilitation, were documented by seven studies, and the rates ranged between 4% and 55%. Most studies reported no or mild adverse effects. Conclusion: Topiramate was effective in terminating refractory status epilepticus, presented relatively low mortality and was well tolerated. Therefore, topiramate could be a good option as a third-line therapy for refractory status epilepticus, but further studies are necessary. [ABSTRACT FROM AUTHOR]

Primary hypoparathyroidism is an endocrine disease rarely diagnosed in dogs, characterized by the reduction of parathyroid hormone synthesis, resulting in metabolic disorders such as hypocalcemia and hyperphosphatemia. Patients may develop severe neurological and neuromuscular conditions secondary to this electrolyte imbalance. A 6-year-old spayed female Spitz dog was brought to the emergency service at WeVets Rebouças Veterinary Hospital, Brazil, presenting tonic-clonic seizures, without any previous history. After initial stabilization with benzodiazepines, severe hypocalcemia (0.65 mmol/L) was diagnosed through venous blood gas analysis. The patient was hospitalized for intravenous calcium replacement with calcium gluconate at 10%, at a dose of 0.5 to 1.0 ml/kg, and later maintained on continuous infusion due to persistent hypocalcemia. Following further examinations, including a PTH measurement of 5.30 pg/mL, alongside 25 (OH) Vitamin D 62 ng/mL, phosphorus levels of 9 mg/dL and magnesium levels of 1.61 mg/dL, a diagnosis of primary hypoparathyroidism was established. Treatment was initiated with calcitriol replacement at 20-50 ng/kg, with the later addition of calcium carbonate at 2 g/day and a phosphorus-binding agent at 30 mg/kg due to difficulty in stabilizing calcium levels. Following these interventions, the patient showed a good therapeutic response and was discharged. Currently, the patient is exclusively on calcitriol at 5 ng/kg, presenting with calcium, and phosphorus values within the reference ranges with no recurrence of epileptic seizures. Although rare, hypoparathyroidism should be considered as a differential diagnosis in dogs presenting with epileptic seizures preceded by hypocalcemia. [ABSTRACT FROM AUTHOR]

Epilepsy is the result of a temporary physiological dysfunction of the brain, caused by an abnormal and self-limited hyper synchronous electrical discharge of cortical neurons. However, knowledge about this condition is still very obscure for a large part of the population. This study aimed to evaluate the level of knowledge of physical education professionals and trainees working in the city of Ilhéus, Bahia regarding the epilepsy, safety precautions and understanding of the positive effect of exercise on this disorder. The data were obtained using a structured questionnaire applied to teachers and trainees who worked in the orientation and prescription of exercises in twelve academies spread throughout the territory of the municipality. As a general profile of the professionals approached were found male individuals, youth and teachers of bodybuilding. As for the knowledge about epilepsy, in most of the questions most of the interviewees had basic notions of what was involved, but how to approach a convulsion with at least 50% was not so assertive and demonstrated not knowing how to carry before an epileptic event. It was possible to conclude that although there is knowledge about epilepsy, it is still necessary to disseminate more consistent information, both within the university academic environment, as well as the media to reinforce correct actions in the face of a convulsion and the consolidation of this information in the middle of work where physical exercises are performed. [ABSTRACT FROM AUTHOR]