[Electroencephalography - from the past to the present - the development during the 100 years after Berger].

In 1924 the German psychiatrist Hans Berger made the first electroencephalographical (EEG) recording of cerebral activity in humans. Worldwide, EEG developed into a widely used diagnostic method and was introduced in Sweden in 1937. Today EEG is an essential diagnostic and monitoring standard in epilepsy, sleep disorders, neonatology and intensive care, and provides prognostic information after perinatal asphyxia and cardiac arrest.

Swedish consensus reached on recording, interpretation and reporting of neonatal continuous simplified electroencephalography that is supported by amplitude-integrated trend analysis.

Unlabelled: Continuous monitoring of electroencephalography (EEG), with a focus on amplitude-integrated EEG (aEEG), has been used in neonatal intensive care for decades. A number of systems have been suggested for describing and quantifying aEEG patterns. Extensive full-montage EEG monitoring is used in specialised intensive care units.

[Status epilepticus in children and adults].

Status epilepticus, a condition with prolonged or repeated seizures, is a common neurological emergency with significant morbidity and mortality. This text outlines the treatment and initial work-up for convulsive and non-convulsive status epilepticus in adults and children. The most serious form is convulsive (tonic-clonic) status epilepticus, which requires rapid treatment and work-up.

A humidifier in the invasive mode during noninvasive respiratory support could increase condensation and thereby impair airway patency.

Aim: Humidifying noninvasively ventilated preterm infants is critical to prevent dehydration of respiratory mucosa, but over-humidification can result in impaired airway patency and lung mechanics. This neonatal bench study investigated the humidity delivered using invasive and noninvasive humidification modes during nasal continuous positive airway pressure.

Methods: The study was conducted at the neonatal intensive care unit of Emma Children's Hospital, the Netherlands, in March 2014.

Cranial Nerve Coactivation and Implication for Nerve Transfers to the Facial Nerve.

In reanimation surgery, effortless smile can be achieved by a nonfacial donor nerve. The underlying mechanisms for this smile development, and which is the best nonfacial neurotizer, need further clarification. The aim of the present study was therefore to further explore the natural coactivation between facial mimic muscles and muscles innervated by the most common donor nerves used in smile reanimation.

Human skeletal muscle type 1 fibre distribution and response of stress-sensing proteins along the titin molecule after submaximal exhaustive exercise.

Early responses of stress-sensing proteins, muscle LIM protein (MLP), ankyrin repeat proteins (Ankrd1/CARP and Ankrd2/Arpp) and muscle-specific RING finger proteins (MuRF1 and MuRF2), along the titin molecule were investigated in the present experiment after submaximal exhaustive exercise. Ten healthy men performed continuous drop jumping unilaterally on a sledge apparatus with a submaximal height until complete exhaustion. Five stress-sensing proteins were analysed by mRNA measurements from biopsies obtained immediately and 3 h after the exercise from exercised vastus lateralis muscle while control biopsies were obtained from non-exercised legs before the exercise.

Risk Factors for Pediatric Extubation Failure: The Importance of Respiratory Muscle Strength.

Objective: Respiratory muscle weakness frequently develops during mechanical ventilation, although in children there are limited data about its prevalence and whether it is associated with extubation outcomes. We sought to identify risk factors for pediatric extubation failure, with specific attention to respiratory muscle strength.

Design: Secondary analysis of prospectively collected data.

Comparison between adaptive and fixed stimulus paired-pulse transcranial magnetic stimulation (ppTMS) in normal subjects.

Objectives: Paired-pulse TMS (ppTMS) examines cortical excitability but may require lengthy test procedures and fine tuning of stimulus parameters due to the inherent variability of the elicited motor evoked potentials (MEPs) and their tendency to exhibit a 'ceiling/floor effects' in inhibition trials. Aiming to overcome some of these limitations, we implemented an 'adaptive' ppTMS protocol and compared the obtained excitability indices with those from 'conventional' fixed-stimulus ppTMS.

Methods: Short- and long interval intracortical inhibition (SICI and LICI) as well as intracortical facilitation (ICF) were examined in 20 healthy subjects by adaptive ppTMS and fixed-stimulus ppTMS.

Pediatric extubation readiness tests should not use pressure support.

Purpose: Pressure support is often used for extubation readiness testing, to overcome perceived imposed work of breathing from endotracheal tubes. We sought to determine whether effort of breathing on continuous positive airway pressure (CPAP) of 5 cmH2O is higher than post-extubation effort, and if this is confounded by endotracheal tube size or post-extubation noninvasive respiratory support.

Methods: Prospective trial in intubated children.

Outcomes of multilobar resections for epilepsy in Sweden 1990-2013: a national population-based study.

Background: Reports on outcome after multilobar resection (MLR) are scarce and most are retrospective single-centre studies or case studies with few patients. The aim of this study is to present seizure and complication outcomes 2 years after MLR in a prospective population-based series.

Method: The Swedish National Epilepsy Surgery Registry (SNESUR) provides prospective population-based data on outcome and complications after epilepsy surgery.

Prospective and longitudinal long-term employment outcomes after resective epilepsy surgery.

Objective: To investigate long-term employment outcomes after resective epilepsy surgery in a national population-based cohort of adults.

Methods: In the Swedish National Epilepsy Surgery Register, all adults who were operated with resective epilepsy surgery from 1995 to 2010 were identified. Two-year follow-up was available for 473/496, 5-year follow-up for 220/240, 10-year follow-up for 240/278, and 15-year follow-up for 85/109 patients.

Evaluating Risk Factors for Pediatric Post-extubation Upper Airway Obstruction Using a Physiology-based Tool.

Rationale: Subglottic edema is the most common cause of pediatric extubation failure, but few studies have confirmed risk factors or prevention strategies. This may be due to subjective assessment of stridor or inability to differentiate supraglottic from subglottic disease.

Objectives: Objective 1 was to assess the utility of calibrated respiratory inductance plethysmography (RIP) and esophageal manometry to identify clinically significant post-extubation upper airway obstruction (UAO) and differentiate subglottic from supraglottic UAO.

In vitro study on work of breathing during non-invasive ventilation using a new variable flow generator.

Objective: In an attempt to reduce the work of breathing (WOB) and the risk of respiratory failure, preterm infants are increasingly treated with nasal synchronised biphasic positive airway pressure (BPAP) via the Infant Flow SiPAP system. However, the relatively high resistance of the generator limits the pressure amplitude (PA) and pressure build-up (PB) of this system. This in vitro study investigates the impact of a new generator with improved fluid mechanics on the WOB, PA and PB during BPAP.

Complications of epilepsy surgery in Sweden 1996-2010: a prospective, population-based study.

Object: Detailed risk information is essential for presurgical patient counseling and surgical quality assessments in epilepsy surgery. This study was conducted to investigate major and minor complications related to epilepsy surgery in a large, prospective series.

Methods: The Swedish National Epilepsy Surgery Register provides extensive population-based data on all patients who were surgically treated in Sweden since 1990.

Respiratory inductance plethysmography calibration for pediatric upper airway obstruction: an animal model.

Background: We sought to determine optimal methods of respiratory inductance plethysmography (RIP) flow calibration for application to pediatric postextubation upper airway obstruction.

Methods: We measured RIP, spirometry, and esophageal manometry in spontaneously breathing, intubated Rhesus monkeys with increasing inspiratory resistance. RIP calibration was based on: ΔµV(ao) ≈ M[ΔµV(RC) + K(ΔµV(AB))] where K establishes the relationship between the uncalibrated rib cage (ΔµV(RC)) and abdominal (ΔµV(AB)) RIP signals.

Operational prototyping a tool for delivering value.

Operational prototyping is a disciplined approach to developing best practices that enable an organization to enhance value through improved quality of care and reduced costs. The aim of operational prototyping is to fine-tune performance to the level of best practices by considering every element involved in a care process, including the design of the facilities required to support the process. The broad goal of this approach is to be able to standardize and replicate the identified best practices in every location across a health system.

Outcomes after resective epilepsy surgery in patients over 50 years of age in Sweden 1990-2009--a prospective longitudinal study.

Purpose: Most epilepsy surgery candidates are young adults. Outcome reports after epilepsy surgery in patients ≥50 years are few and varying. The aim of this study was to describe patient characteristics of older compared to younger adults and analyse seizure, complication and vocational outcomes in a large population-based series.

Trigeminal nerve stimulation does not acutely affect cortical excitability in healthy subjects.

Background: Trigeminal nerve stimulation (TNS) has recently emerged as a new therapeutic option for patients with drug-resistant epilepsy but its potential mechanisms of action are not known. Since other antiepileptic treatments have been shown to alter cortical excitability, thereby reducing the liability to seizures, it has been suggested that cranial nerve stimulation such as TNS may act in the same way.

Objective: To study whether TNS has the potential to alter cortical excitability in healthy subjects.

Long-term follow-up after callosotomy--a prospective, population based, observational study.

Objective: Analyze the long-term outcome of callosotomies with regard to seizure types and frequencies and antiepileptic drug treatment.

Methods: This longitudinal observational study is based on data from the prospective Swedish National Epilepsy Surgery Register. Thirty-one patients had undergone callosotomy in Sweden 1995-2007 and had been followed for 2 and 5 or 10 years after surgery.

Complications to invasive epilepsy surgery workup with subdural and depth electrodes: a prospective population-based observational study.

Objective: In some patients who undergo presurgical workup for drug-resistant epilepsy invasive seizure monitoring is needed to define the seizure onset zone and delineate eloquent cortex. Such procedures carry risks for complications causing permanent morbidity and even mortality. In this study, prospective data on complications in a national population-based sample were analysed.

Long-term outcomes of epilepsy surgery in Sweden: a national prospective and longitudinal study.

Objective: To investigate prospective, population-based long-term outcomes concerning seizures and antiepileptic drug (AED) treatment after resective epilepsy surgery in Sweden.

Methods: Ten- and 5-year follow-ups were performed in 2005 to 2007 for 278/327 patients after resective epilepsy surgery from 1995 to 1997 and 2000 to 2002, respectively. All patients had been prospectively followed in the Swedish National Epilepsy Surgery Register.