INTRODUÇÃO: Estima-se que um terço dos casos de pacientes com espectro autista vai apresentar ao menos uma crise epiléptica até a adolescência. Esta associação entre transtornos invasivos do desenvolvimento e epilepsia vem sendo amplamente estudada, mas ainda com inúmeros questionamentos sem resposta na literatura. OBJETIVO: Os autores apresentam o caso de uma criança, com quadro de Transtorno Invasivo do Desenvolvimento - espectro autista - e epilepsia de difícil controle submetida à cirurgia, revisando aspectos fundamentais desta associação. CONCLUSÃO: A partir do caso em questão e de estudos existentes, é pertinente questionar quais são os indícios que nos fazem acreditar que crises epilépticas recorrentes ou uma atividade elétrica anormal sejam responsáveis por alterações cognitivas, de linguagem ou de conduta e qual o tratamento ideal para estas crianças nas quais co-existem os dois diagnósticos.

INTRODUCTION: Some reports have indicated that one third of children with autistic spectrum disorder will present at least one seizure untill early adolescence. The association between autism and epilepsy is recognized but remains unresolved and poorly understood. OBJECTIVE: The authors present a child with autistic spectrum disorder and infantile spasms in the first year of life who underwent resective surgery for intractable epilepsy and discuss aspects of this relationship. CONCLUSION: Despite a growing number of studies involving autism and epilepsy we must point out how is the evidence that recurrent seizures or abnormal electrical activity can cause cognitive, language or behavioral abnormalities and what is the ideal treatment for these children in whom a neurodevelopmental disorder coexists with epilepsy.

INTRODUÇÃO: Pacientes com epilepsia generalizada primária (idiopática) podem, raramente, não responder ao tratamento medicamentoso e assim apresentar crises tônico-clônicas generalizadas (CTCG) recorrentes, incapacitantes e que colocam o paciente em risco de complicações graves. OBJETIVO: Nesse artigo é relatado o caso de um paciente com epilepsia generalizada primária e CTCG semanais, refratárias a diversos esquemas medicamentosos, que foi submetido a uma calosotomia. RESULTADO: No curto espaço de 3 meses de seguimento pós-operatório, o paciente não mais apresentou CTCG. CONCLUSÃO: A calosotomia pode ser um procedimento útil na redução da freqüência de CTCG refratárias, mesmo em pacientes com epilepsia generalizada primária.

INTRODUCTION: Patients with idiophatic generalized epilepsy (IGE) may occasionally have frequent generalized tonic-clonic seizures (GTCS) which are not adequantely controlled by antiepileptic drugs. Frequent GTCS pose a significant risk of injury and other complications. In symptomatic generalized epilepsies, corpus callosotomy (CC) has been shown to be effective in reducing the number of generalized seizures. OBJECTIVE: We report a patient with refractory, weekly GTCS in the context of a primary generalized epilepsy syndrome who underwent subtotal CC. RESULT: In the 3 months since operation, no GTCS occurred. CONCLUSION: Corpus callosotomy can be helpful in reducing medically-refractory GTCS, even in patients with primary generalized epilepsies.

OBJECTIVE: To determine the clinical characteristics and the results of bronchoscopic treatment of children due to foreign body aspiration in a university hospital. METHOD: Time series of children who underwent bronchoscopies for foreign bodies aspirated into the airway between March 1993 and July 2002. Each patient was analyzed for age, sex, initial clinical diagnosis, nature and location of the foreign body, duration of symptoms between aspiration and bronchoscopy, radiological findings, results of bronchoscopic removal, complications of bronchoscopy and presence of foreign bodies in the airways. RESULTS: Thirty-four children, 20 (59%) boys, ages ranging from nine months to nine years (median = 23 months). In 32 (94%) children the foreign body was removed by rigid bronchoscope, and two resulted in thoracotomy. Foreign bodies were more frequent in children under three years of age (66%). A clinical history of foreign body inhalation was obtained in 27 (80%) cases. Most of the foreign bodies removed were organic (65%) and more frequently found in the right bronchial tree (59%). Foreign bodies were removed within 24 hours in 18 (53%) cases. The most frequent radiographic findings were: unilateral air trapping, atelectasis and radiopac foreign body. Major bronchoscopy complications occurred in seven children (22%), and there were no deaths. CONCLUSIONS: More attention is necessary to the respiratory symptoms of aspirations, mainly in boys at early ages, with clinical history and compatible radiological findings. Most foreign bodies removed were of organic nature. In this case series, therapeutic rigid bronchoscopy was effective with few complications.