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- Ryvlin, Philippe, et al.
(författare)
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Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS) : a retrospective study
- 2013
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 12:10, s. 966-977
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Tidskriftsartikel (refereegranskat)abstract
- Background Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in people with chronic refractory epilepsy. Very rarely, SUDEP occurs in epilepsy monitoring units, providing highly informative data for its still elusive pathophysiology. The MORTEMUS study expanded these data through comprehensive evaluation of cardiorespiratory arrests encountered in epilepsy monitoring units worldwide. Methods Between Jan 1,2008, and Dec 29,2009, we did a systematic retrospective survey of epilepsy monitoring units located in Europe, Israel, Australia, and New Zealand, to retrieve data for all cardiorespiratory arrests recorded in these units and estimate their incidence. Epilepsy monitoring units from other regions were invited to report similar cases to further explore the mechanisms. An expert panel reviewed data, including video electroencephalogram (VEEG) and electrocardiogram material at the time of cardiorespiratory arrests whenever available. Findings 147 (92%) of 160 units responded to the survey. 29 cardiorespiratory arrests, including 16 SUDEP (14 at night), nine near SUDEP, and four deaths from other causes, were reported. Cardiorespiratory data, available for ten cases of SUDEP, showed a consistent and previously unrecognised pattern whereby rapid breathing (18-50 breaths per min) developed after secondary generalised tonic-clonic seizure, followed within 3 min by transient or terminal cardiorespiratory dysfunction. Where transient, this dysfunction later recurred with terminal apnoea occurring within 11 min of the end of the seizure, followed by cardiac arrest. SUDEP incidence in adult epilepsy monitoring units was 5.1 (95% CI 2.6-9.2) per 1000 patient-years, with a risk of 1.2 (0.6-2.1) per 10 000 VEEG monitorings, probably aggravated by suboptimum supervision and possibly by antiepileptic drug withdrawal. Interpretation SUDEP in epilepsy monitoring units primarily follows an early postictal, centrally mediated, severe alteration of respiratory and cardiac function induced by generalised tonic-clonic seizure, leading to immediate death or a short period of partly restored cardiorespiratory function followed by terminal apnoea then cardiac arrest. Improved supervision is warranted in epilepsy monitoring units, in particular during night time.
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| 3. |
- Lerche Nielsen, Michael
(författare)
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Runic Inscriptions Reflecting Linguistic Contacts between West Slav Lands and Southern Scandinavia
- 2014
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Ingår i: Scripta Islandica. - 0582-3234 .- 2001-9416. ; 65, s. 153-172
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Tidskriftsartikel (refereegranskat)abstract
- This article discusses the discrepancy between historical accounts of the contacts between Scandinavians and West Slavs in the late Viking Age and early Middle Ages on the one hand and linguistic evidence — loan words, place-names, personal names, and runic inscriptions — on the other. The main focus is the small corpus of runic inscriptions found in urban contexts along the south coast of the Baltic Sea. The inscriptions were previously seen as signs of hostilities, but the finds from Starigard (Oldenburg) in particular now point in a much more peaceful direction. The runic texts represent a high degree of literacy and the text types are very similar to finds from urban runic finds in mainland Scandinavia. This suggests a state of peaceful co-existence between Scandinavians and West Slavs and a permanent presence in the Slavic Towns, for instance of a diplomatic or mercantile nature or by a band of mercenaries.
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