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Introduction: Morvan’s syndrome is a rare neurological condition characterized by the combination of central and peripheral symptoms such as neuromyotonia by fasciculation, dysautonomy and encephalopathy associated with laboratory evidence of the VGKC antibodies LGI1 and CASPR2. Case report: A 77-year-old man was admitted to the emergency room with a 3-month history of mental confusion, alteration in memory and language, visual and auditory hallucinations, and seizures. He had a sudden decrease level of consciousness and generalized myoclonus, being admitted to the intensive care unit. Due to non-improvement of the neurological condition, the possibility of encephalitis rose, herpes simplex virus (HSV) polymerase chain reaction (PCR) and 14.3.3 protein in cerebrospinal fluid (CSF) were performed, which resulted negative later. Analysis of CSF showed a high level of protein and cells. Magnetic resonance imaging (MRI) of the brain showed hypersignal activity in the bilateral internal capsule, temporal and frontal region. An extensive propaedeutic was performed for rapidly progressive dementia, including an autoimmune panel, with anti-glioma rich in inactivated leucine 1 (LGI-1) positive by indirect immunofluorescence. Discussion: the diagnosis of Morvan’s Syndrome is clinical. Some cases are reported with spontaneous remission and others that require extensive treatment, with immunotherapy, including plasmapheresis and immunosuppression. VGKC antibodies have been reported in association with three main clinical syndromes: neuromyotonia, Morvan’s syndrome and limbic encephalitis.

Purpose: To establish cutoff points for the analysis of the Behavior Observation Form (BOF) of children in the ages of 2 to 23 months and evaluate the sensitivity and specificity by age group and domains (Emission, Reception, and Cognitive Aspects of Language). Methods: The sample consisted of 752 children who underwent BOF. Each child was classified as having appropriate language development for the age or having possible risk of language impairment. Performance Indicators (PI) were calculated in each domain as well as the overall PI in all domains. The values for sensitivity and specificity were also calculated. The cutoff points for possible risk of language impairment for each domain and each age group were obtained using the receiver operating characteristics curve. Results: The results of the study revealed that one-third of the assessed children have a risk of language impairment in the first two years of life. The analysis of BOF showed high sensitivity (>90%) in all categories and in all age groups; however, the chance of false-positive results was higher than 20% in the majority of aspects evaluated. It was possible to establish the cutoff points for all categories and age groups with good correlation between sensitivity and specificity, except for the age group of 2 to 6 months. Conclusion: This study provides important contributions to the discussion on the evaluation of the language development of children younger than 2 years. Objetivo: Estabelecer pontos de corte para análise do Protocolo de Observação de Comportamentos (POC) na faixa etária de 2 a 23 meses completos e avaliar a sensibilidade e a especificidade por faixa de idade e por domínios (Emissão, Recepção e Aspectos cognitivos da linguagem). Métodos: A casuística consistiu em 752 crianças que foram submetidas ao POC. Cada criança foi classificada com desenvolvimento da linguagem adequado para a idade ou com possível risco de alteração da linguagem. Foram calculados os Índices de desempenho (ID) em cada domínio e o ID geral. Também foram calculados os valores de sensibilidade e especificidade e, por meio da curva ROC, determinados os pontos de corte para possível risco de alteração de linguagem para cada domínio e faixas de idade. Resultados: Os resultados do estudo revelaram que um terço das crianças avaliadas apresenta risco de alteração de linguagem nos dois primeiros anos de vida. A análise do POC revelou alta sensibilidade (>90%) em todas as categorias e em todas as faixas de idade, contudo a chance de resultados falso-positivos foi superior a 20% na maioria dos aspectos avaliados. Foi possível estabelecer os pontos de corte para todas as categorias e faixas de idade com boa correlação entre sensibilidade e especificidade, exceto para a faixa etária de 2 a 6 meses. Conclusão: O presente estudo traz contribuições importantes para a discussão sobre a avaliação do desenvolvimento de linguagem de crianças menores que 2 anos.

Simple and sensitive methods using high-performance liquid chromatography-diode array detection (HPLC-DAD) and ultraviolet (UV)-spectrophotometry were developed and compared to quantify lychnopholide (LYC) in poly-e-caprolactone nanocapsules and to study its release kinetics. Both methods were validated concerning their specificity, linearity, limits of detection and quantification, precision, accuracy and stability. HPLC-DAD analyses were conducted using an RP C18 column, isocratic elution with a methanol-water (60:40 v/v) mobile phase at 0.8 mL/min flow rate and detection at 265 nm. The linear response (r(2) > 0.999) was obtained within a concentration range of 2-25 µg/mL using HPLC-DAD and 5-40 µg/mL using spectrophotometry. Intra-day and inter-day precision were obtained with low relative standard deviation values. The accuracy of the methods was within the range 98-101% for HPLC-DAD and from 96-100% for UV-spectrophotometry. Both methods were suitable to be applied for the determination of drug loading percentage (>96%) and encapsulation efficiency (>90%). Furthermore, the sensitivity of HPLC-DAD method allows studies of LYC release/dissolution in sink conditions. LYC presented 100% dissolution after 24 h, whereas only 60% of LYC was released from the nanocapsule dosage form, with no burst effect. The methods fulfilled all validation parameters evaluated for LYC quantification in the polymeric nanocapsules and have proven to be accurate, selective and sensitive in the previously mentioned applications.