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By Ekbia, H. R.

ISBN-10: 051147878X

ISBN-13: 9780511478789

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An elevated cell count would b e unexpected because the disease is thought to lie distally in the peripheral nerves, but abnormal cells might indicate a neoplastic or inflammatory infiltrate. The CSF protein is elevated in patients with a demyelinating neuropathy such as that seen in patients with diabetes or the Guillain-Barré syndrome but would b e expected to b e normal in patients with an axonal neuropathy or mononeuritis multiplex, as would be the opening pressure and IgG content. 51 Questions 5.

Depression should b e treated with drugs rather than EOT which may further damage the brain. (b) Cranial CT should b e used to assess structural damage including cerebral atrophy secondary to infarction. Prog­ nosis depends on the degree of infarction. g. hydrocephalus or a subdural haematoma, should b e excluded. Comment He had a severe closed head injury (PTA 3 weeks) with cortical contusion and traumatic subarachnoid haemorrhage. A subdural haematoma was shown on cranial CT 3 weeks after the injury.

Examination at rest was normal. On exercise, when sympto­ matic, there was weakness in plantiflexion and neither ankle reflex could b e elicited. The patient underwent myelography (Figure 2b). Question 1. What is the most probable diagnosis? 38 Answers 1. The patient gives a history of claudication of the cauda equina which results from an inadequate blood supply to the lumbar roots. This is associated with congenital lumbar canal stenosis or, more rarely, Paget's disease or arachnoiditis following meningitis or myodil myelography.

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Artificial dreams : the quest for non-biological intelligenc by Ekbia, H. R.


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