Neurology
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A patient with a selective deficit in retrieving proper names after left temporal lobectomy is reported. He showed proper name anomia in conversation, in response to photographs, and in verbal descriptions, despite being able to provide semantic information about the people he was unable to name. This report provides evidence that the rostral part of the left temporal lobe plays a crucial role in processing proper names without involvement of other verbal functions.
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To report neuroimaging findings in patients with complex partial status epilepticus. ⋯ The radiologic characteristics of status epilepticus resemble those of ischemic stroke but can be differentiated based on lesion location and findings on MRA and postcontrast MRI. The MRI abnormalities indicated the presence of cytotoxic and vasogenic edema, hyperperfusion of the epileptic region, and alteration of the leptomeningeal blood-brain barrier. These changes reversed, but they resulted in some regional brain atrophy.
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In 18 patients with idiopathic restless legs syndrome (RLS), intracortical inhibition by paired transcranial magnetic stimulation (TMS) was significantly reduced for both foot and hand muscles, suggesting that the entire motor cortex is disinhibited in RLS. Decreased intracortical facilitation in the foot muscle but not in the hand muscle may be due to subliminal activation of the symptomatic lower limbs. Motor excitability measurements of single TMS were not altered. These results support a subcortical origin of RLS.
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Functional MRI (fMRI) is of potential value in determining hemisphere dominance for language in epileptic patients. ⋯ This fMRI method shows potential for evaluating language dominance in patients with a variety of brain lesions.
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To study the short-term effects of slow repetitive transcranial magnetic stimulation (rTMS) of the motor cortex on cortical excitability and handwriting in patients with writer's cramp. ⋯ In some patients 1-Hz rTMS can reinforce deficient intracortical inhibition and may improve handwriting temporarily. Our data support the notion that reduced intracortical inhibition plays a part in the pathophysiology of focal dystonia.