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Neurological symptoms in COVID-19 patients can also be found in the pediatric population, but they are usually described as mild symptoms. Herein, we described a case series of four pediatric patients with severe and highly heterogeneous central and peripheral nervous system manifestations. The objective was to report neurological manifestations of COVID-19 in children and adolescents. The design is case series. The participants are four children and adolescents with confirmed COVID-19. The main outcome and measures are as follows: Clinical data were gathered from electronic medical records, and data of all neurologic symptoms were checked by a trained neurologist. We reported four pediatric patients with COVID-19 and different neurologic symptoms. Case 1 was a 16-year-old girl with a sensory and motor polyradiculopathy with RT-qPCR for COVID-19 and dengue both detected in CSF that improved after appropriate treatment. Case 2 was a 15-year-old boy with Guillain-Barre syndrome and had good response after using human immunoglobulin. Case 3 was a 5-year-old girl with acute intracranial hypertension that improved after going through lumbar puncture and using acetazolamide. Case 4 was a 2-month-old male infant with focal epileptic seizures that recovered after antiepileptic treatment. We highlight the need to consider different neurologic manifestations as part of the COVID-19 clinical spectrum.

Background Brazil experienced a disproportionately higher rate of microcephaly cases in November 2015 with evidence of a causal link with Zika virus (ZIKV) infections during pregnancy. Epilepsy is a major neurological feature seen as part of congenital Zika virus syndrome (CZVS). Different seizure types and electroencephalographic (EEG) abnormalities have been described in association with this syndrome. However, clinical and neurophysiological features of epilepsy seen in children with CZVS are not fully understood. Methods We evaluated children with CZVS showing an EEG pattern of electrical status epilepticus during slow-wave sleep (ESES). Information on gender, age of onset of seizures, head circumference at birth, gross motor function at the time of diagnosis, of clinical and EEG aspects of seizures, EEG features and response to drug treatment was assessed. Results Our case series included four patients. They were diagnosed with epilepsy between one month to 18 months of age and showed an ESES pattern at the age of three. They presented with a wide range of epileptic symptoms, but all experienced tonic seizures. Multiple drug treatment was the management approach for three patients; however, they showed poor response to treatment with conventional drugs used in the treatment of ESES. Conclusions Children with CZVS may develop an EEG pattern of ESES. Clinicians and neurologists should be aware of this neurological presentation to improve the management of these patients.

Introdução. Numerosos estudos publicados durante recentemente demonstram os impactos adversos da poluição do ar na saúde humana, sendo o cérebro em desenvolvimento mais susceptível. Objetivos. Este artigo é uma revisão da literatura de artigos sobre poluição no cérebro em desenvolvimento, desde o período pré-natal e infância. O objetivo dessa revisão foi mostrar as evidências existentes que associam a exposição aos poluentes ambientais e consequências ao cérebro em desenvolvimento. Método. Foram realizadas buscas de artigos relacionados à poluição do ar e seus efeitos no sistema nervoso na base de dados MEDLINE. Resultados. Estudos apontam para relações entre déficit cognitivo e exposição a poluentes como o material particulado, chumbo e mercúrio em crianças cujas mães foram a expostas a esses materiais. Os hidrocarbonetos aromáticos policíclicos estão relacionados com atraso global do desenvolvimento e déficit pondero-estatural. Conclusão. Os poluentes atmosféricos são responsáveis por vários efeitos deletérios nos sistemas em desenvolvimento incluindo o sistema nervoso central