Seizures are the most common neurological emergency in the neonatal period and in contrast to those in infancy and childhood, are often provoked seizures with an acute cause and may be electrographic‐only. Hence, neonatal seizures may not fit easily into classification schemes for seizures and epilepsies primarily developed for older children and adults. A Neonatal Seizures Task Force was established by the International League Against Epilepsy (ILAE) to develop a modification of the 2017 ILAE Classification of Seizures and Epilepsies, relevant to neonates. The neonatal classification framework emphasizes the role of electroencephalography (EEG) in the diagnosis of seizures in the neonate and includes a classification of seizure types relevant to this age group. The seizure type is determined by the predominant clinical feature. Many neonatal seizures are electrographic‐only with no evident clinical features; therefore, these are included in the proposed classification. Clinical events without an EEG correlate are not included. Because seizures in the neonatal period have been shown to have a focal onset, a division into focal and generalized is unnecessary. Seizures can have a motor (automatisms, clonic, epileptic spasms, myoclonic, tonic), non‐motor (autonomic, behavior arrest), or sequential presentation. The classification allows the user to choose the level of detail when classifying seizures in this age group.

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To describe the long-term effects of nasal continuous positive airway pressure (CPAP) on the rate of traffic car accidents, excessive daytime sleepiness (EDS) and mood in patients with obstructive sleep apnoea syndrome (OSAS), we investigated the changes of these parameters before and after nasal CPAP treatment using a questionnaire. Seventy-five male patients who were diagnosed with severe OSAS by polysomnography were evaluated for driving competence, by looking at their driving history for 2 yr, for EDS by the Epwarth Sleepiness Scale (ESS) and for mood by the Self-related Depression Scale (SDS), and then underwent nasal CPAP treatment. After 2 yr of treatment, questionnaires inquiring about the patients' use of CPAP, their ESS, SDS and driving history during treatment were sent to the patients. A total of 47 patients (63%) responded to these questionnaires. Forty-six of the 47 responders had continued to use the nasal CPAP and completed the questionnaire. No traffic car accidents were observed among the 39 routine car users during treatment, while 13 of 39 patients (33%) had had car accidents before treatment. Although near-miss accidents had been reported by 32 of 39 patients (82%) before treatment, only four patients reported near-miss accidents during nasal CPAP treatment. The mean score of ESS was significantly (P<0.01) reduced in 46 patients after nasal CPAP. The mean score of SDS was also decreased (P<0.01) after nasal CPAP in 46 patients. Although 26 of 41 patients had been depressive on SDS before treatment, the mood was improved in 13 patients after nasal CPAP. These results suggest that long-term nasal CPAP treatment reduces the rate of traffic car accidents and improves the EDS and the mood in patients with OSAS.

Our pervious electron microscopic studies indicated that Merkel cells (MCs) in the gerbil palatine mucosa were polymorphic, possibly reflecting different function. In order to verify and extend this evidence, the shape of and the innervation to MCs in the palatine mucosa of six different species of rodents including the Mongolian gerbil and the rat were examined by immunohistochemistry and transmission electron microscopy. Immunohistochemistry using anti-cytokeratin 20 (CK20) antibody revealed that in the gerbil palatine mucosa, approximately half of MCs were dendritic. Confocal laser scanning microscopy after double labeling with anti-cytokeratin and anti-PGP 9.5 or anti-Na+/K(+)-ATPase beta 1 subunit antibodies indicated that most of the dendritic MCs (DMCs) in these mucosae were free of innervation. Electron microscopy showed that all species of rodents examined contained abundant dendritic MCs as well as roundish (oval to round) MCs (RMCs) with typical innervation. Secretory granules of the RMCs were usually concentrated at the synaptic site, whereas those of the DMCs tended to accumulate in the tips of the cytoplasmic processes and in the cytoplasm facing the basal lamina. Some MCs showed features intermediate between those of the RMC and DMC. These results indicate that MCs in rodent palatine mucosae are consistently polymorphic, and that DMCs may represent a distinctive subset with specific, presumably including endocrine and paracrine, functions different from those of RMCs.

To assess the acute effects of nasal continuous positive airway pressure (CPAP) on the 24-hour blood pressure and the secretion of catecholamines in urine and plasma, we investigated the changes in the 24-hour blood pressure and urinary and plasma concentrations of epinephrine (E) and norepinephrine (NE) in 26 men with obstructive sleep apnea (OSA) with and without nasal CPAP. Nasal CPAPresulted in significant decreases in the daytime diastolic pressure (from 86 ± 16 mmHgto 83 ± 12 mmHg), the nighttime diastolic pressure (from 81 ± 12 mmHgto 77 ±9 mmHg) and the nighttime systolic pressures (from 125 ± 15 mmHgto 120 ± 10 mmHg). There was no significant difference between patients with and without CPAPin the daytime or nighttime urinary E level, but patients who received CPAPshowed a significant decrease in daytime urinary NElevel (from 156± 112 |ig/14h to 119 ± 101 |0g/14h) and nighttime urinary NE level (from 143 ±91 |ig/10h to 112 ± 65 |ig/10h). The morning plasma level of NE also decreased (from 371 ± 181 pg/ml to 273 ± 148 pg/ml) in patients who received nasal CPAP (p<0.02), but the plasma level of E remained unchanged. There were no correlations between PSGparameters and the reductions in blood pressure and the catecholamine levels induced by nasal CPAP.These findings suggest that OSA contributes, at least in part, to the development of systemic hypertension by increasing sympathetic nervous activity.