| 1. |
- Greisen, G, et al.
(författare)
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EEG depression and germinal layer haemorrhage in the newborn
- 1987
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 76:3, s. 519-525
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Tidskriftsartikel (refereegranskat)abstract
- Amplitude integrated EEG (aEEG) recordings from 32 mechanically ventilated infants, gestational age 32 weeks or less, were analysed. All recordings were started within 24 h of birth and continued for at least 50 h. Germinal layer haemorrhage (GLH) was diagnosed by repeated ultrasonography. In six infants neither GLH nor hypocalcaemia were diagnosed; aEEG in these infants rapidly became more active after birth: at 30 h of age continuous background activity was present for more than 20% of the time, and a seizure-like pattern was exceptional. In seven infants without GLH but with hypocalcaemia and other signs of metabolic derangement, continuous background activity appeared later and seizure-like activity was frequent. In the infants with GLH, depression of the background activity was apparent. This finding was particularly distinct in the presence of severe haemorrhages. Four infants developed GLH after 30 h of age. All these infants had depressed aEEG before the development of GLH, with less than 20% continuous activity at 30 h of age. In ten infants an analysis of the aEEG during the occurrence of GLH was possible. In six of these, cortical electrical activity decreased. Due to the limitation of GLH timing, it was not possible to decide whether this decrease closely preceded or followed GLH. We suggest that GLH primarily occurs in brains with a preceding metabolic and neurophysiologic abnormality, and that further functional deterioration is caused by the most severe haemorrhages.
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| 2. |
- Hellström-Westas, Lena, et al.
(författare)
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Cerebral complications detected by EEG-monitoring during neonatal intensive care
- 1989
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Ingår i: Acta paediatrica Scandinavica. Supplement. - : Wiley. - 0300-8843. ; 78:S360, s. 83-86
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Tidskriftsartikel (refereegranskat)abstract
- The report describes the clinical use and value of continuous EEG-monitoring during different clinical circumstances that are not usually related to changes in EEG. Three infants with pneumothorax, hypoglycaemia, and severe hyaline membrane, respectively, are presented.
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| 3. |
- Hellström-Westas, Lena, et al.
(författare)
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Lidocaine for treatment of severe seizures in newborn infants. I. Clinical effects and cerebral electrical activity monitoring
- 1988
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 77:1, s. 79-84
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Tidskriftsartikel (refereegranskat)abstract
- The anticonvulsive effect of lidocaine was evaluated in 46 newborn infants with severe, recurrent seizures. Before the lidocaine all infants were being given phenobarbital, and 22 infants were also treated with diazepam. Different dosages of lidocaine were tested. A loading dose of 2 mg/kg followed by i.v. infusion of 6 mg/kg/hour was the most effective dosage and had an immediate anticonvulsive effect in 18 of 25 infants; within 30 min the same effect was attained in another five of the infants, with an overall seizure control in 92% of the sample population. During the lidocaine treatment cerebral electrical activity was followed continuously with a cerebral function monitor (CFM), which also enabled evaluation of the treatment. No serious side effects on blood-pressure, heart-rate or cerebral electrical activity were registered. For newborn infants with severe recurrent seizures not responding to other drugs, lidocaine is an effective additional mode of treatment.
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| 4. |
- Hellström-Westas, Lena, et al.
(författare)
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Silent seizures in sick infants in early life. Diagnosis by continuous cerebral function monitoring
- 1985
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 74:5, s. 741-748
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral electric activity was surveilled with a Cerebral Function Monitor (CFM) technique in 87 newborn infants under neonatal intensive care. A total of 26 infants had electrographical signs of repeated seizure activity. Among these infants 14 had periods of one hour or more of silent seizures activity. Among these infants 14 had periods of one hour or more of silent seizures, i.e. typical pattern of ictal epileptic activity on CFM without clinical symptoms or signs of convulsions. The occurrence of silent seizures and their pattern in relation to the clinical condition and management was unpredictable in most cases. Besides general limpness or flaccidity in an outward quiet baby these infants showed no clinical fits or clonic convulsions. The findings indicate that anticonvulsive therapy in small infants may be insufficient and need re-evaluation, since the long-term effect of silent seizures on cerebral function and activity is still uncertain.
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| 5. |
- Agardh, Carl-David, et al.
(författare)
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Improvement of peripheral nerve function after institution of insulin treatment in diabetes mellitus. A case-control study
- 1983
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Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 213:4, s. 283-287
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Tidskriftsartikel (refereegranskat)abstract
- The influence of improved diabetic control on peripheral nerve function was studied before and 3-4 months after institution of insulin treatment in 22 diabetics unsatisfactorily controlled by oral hypoglycemic agents. After institution of insulin treatment, diabetic control was improved as demonstrated by decreasing levels of HbA1. There was an overall tendency towards improvement of motor and sensory conduction velocities, however significant only in the upper extremities. There was a tendency towards improved temperature sensitivity in the legs, while no changes occurred in the hands and face. The sensation for vibration did not change. It is concluded that improved diabetic control, even in elderly patients with long-standing diabetes, is followed by neurophysiological signs of improved peripheral nerve function.
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| 6. |
- Agardh, Carl-David, et al.
(författare)
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Persistent vegetative state with high cerebral blood flow following profound hypoglycemia
- 1983
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Ingår i: Annals of Neurology. - : Wiley. - 1531-8249 .- 0364-5134. ; 14:4, s. 482-486
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Tidskriftsartikel (refereegranskat)abstract
- A persistent vegetative state (severe dementia) developed in a 30-year-old man following hypoglycemic coma. Despite the poor clinical outcome, sensory evoked response recovered between 6 and 34 months after the insult. The cerebral blood flow level at rest after 34 months was slightly above the normal range. This finding contrasts with the low cerebral blood flow regularly reported in patients who are comatose or stuporous following severe brain hypoxia-ischemia.
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| 7. |
- Aberg, T, et al.
(författare)
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Cerebral function monitoring in rats with a critical hepatic injury treated with pneumatic antishock garment and infusion
- 1989
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Ingår i: Journal of Trauma. - 0022-5282. ; 29:2, s. 168-174
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-nine rats were subjected to a severe standardized hepatic injury and divided into four groups. In addition to controls, the animals were treated with PASG inflated to 40 mm Hg, PASG and infusion of Ringer's acetate, or PASG and infusion of Ringer's acetate and Dextran 70 in combination. The aim of the infusion therapy was to stabilize the mean aortic blood pressure at 60 mm Hg. PASG significantly prolonged the survival time and the time during which a sensory evoked response could be observed. The PASG also prolonged the time before the EEG amplitude began to decrease or a burst-suppression pattern appeared in the EEG. Intravenous infusion of Ringer's acetate did not prolong these times compared to when PASG was used alone; when Dextran 70 was added to the infusion therapy these times were reduced. Changes in the EEG were recorded at a mean aortic pressure of 60 mm Hg when infusions were given, whereas the aortic pressure had to fall to 40 mm Hg before any changes could be observed when no infusions were used.
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| 8. |
- Agardh, Carl-David, et al.
(författare)
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Neurophysiological recovery after hypoglycemic coma in the rat: correlation with cerebral metabolism
- 1983
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Ingår i: Journal of Cerebral Blood Flow and Metabolism. - 1559-7016. ; 3:1, s. 78-85
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Tidskriftsartikel (refereegranskat)abstract
- Recovery of electroencephalographic activity and somatosensory evoked responses was studied in paralyzed and lightly anesthetized (70% N2O) rats in which profound hypoglycemia had been induced by insulin administration. The duration of severe hypoglycemia was defined as the duration of a flat electroencephalogram (EEG) recording (5, 30, and 60 min, respectively) before restitution with glucose. The restitution period was followed by continuous EEG monitoring and repeated tests for evoked potentials. After 180 min of recovery, the brains were frozen in situ with liquid nitrogen and analyzed for energy metabolism. In accordance with earlier metabolic studies from this laboratory, the recovery after 60 min of severe hypoglycemia was incomplete, with signs of permanent failure of energy metabolism. There was persistent ATP reduction proportional to the duration of the hypoglycemia. The short-term recovery of EEG and sensory evoked responses was proportional to the duration of severe hypoglycemia. The neurophysiological recovery after 5 min of severe hypoglycemia was complete. After 30 min of severe hypoglycemia, the evoked responses recovered but showed a significant prolongation of latency, compared with normal. After 60 min of severe hypoglycemia, no early evoked response and scanty EEG activity were observed. The neurophysiological observations indicate a persistent deficit of synaptic transmission in the somatosensory pathway, including the cortical projection. This can be correlated with neuropathologic changes that are particularly prominent in intermediate cortical layers, as previously shown.
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| 9. |
- Bjerre, I, et al.
(författare)
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Monitoring of cerebral function after severe asphyxia in infancy
- 1983
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Ingår i: Archives of Disease in Childhood. - 1468-2044. ; 58:12, s. 997-1002
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Tidskriftsartikel (refereegranskat)abstract
- Thirty nine infants with severe asphyxia (28 affected perinatally and 11 later) were studied by electrophysiological cerebral function monitoring (CFM) for periods varying from a half to 49 days. Nineteen infants died while still in intensive care and two died later from sequelae. Eighteen survived and were followed up when aged between 8 and 36 months. The initial electroencephalogram (EEG) and the first 12 hours of CFM tracing correlated well. The type of background activity, whether continuous or interrupted, proved to be of high prognostic importance unlike the presence of seizure activity, which bore no distinct correlation to outcome in these severely asphyxiated infants.
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| 10. |
- Greisen, Gorm, et al.
(författare)
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Sleep-walking shifts and cerebral blood flow in stable preterm infants
- 1985
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Ingår i: Pediatric Research. - 1530-0447. ; 19:11, s. 1156-1159
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral blood flow was estimated on 60 occasions in 15 well infants, 29-34 wk of gestational age, 5-17 days after birth, using 133-Xenon clearance after intravenous injection. The sleep state of the infants was determined by biparietal electroencephalography, clinical observation, and tracings of heart rate and respiration. Blood flow was 22% higher in the 11 estimations made during wakefulness, when compared to the 17 estimations made during quiet sleep. There was no difference between blood flow in active and quiet sleep. Also there was no difference between blood flow during periods of trace alternant and blood flow during periods of continuous electroencephalographic activity. It is suggested that flow-metabolism coupling is present in stable, preterm infants. The absence of an increase in cerebral blood flow during active sleep as compared with quiet sleep suggests that the neurophysiologic and neurometabolic mechanisms of rapid eye movement sleep are not yet fully developed in preterm infants.
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