The subject of the apallic syndrome is one which has long been familiar to me, although I have not personally studied it as deeply as I would have wished. I became acquainted with this syndrome long before the last war, when my neurosurgical colleague Hugh Cairns (1952), made his pioneer contribution under the term "akinetic mutism" . This was an ar resting title, but it was one which did not altogether satisfy some of his colleagues, includ ing myself. We found it difficult to suggest an alternative. That is one reason why I wel come the expression "apallic syndrome" . Forensic practice has forced me from time to time to consider rather more deeply this distressing syndrome, and to try and marshal my ideas in a form which would satisfy my colleagues in the legal profession. More than once I have been instructed to make a medico legal assessment of these unfortunate patients. The points which have concerned my lawyer friends have not been matters of diagnosis, or of morbid anatomy, or of etiology. The fac tual problem which has been put before me was to make some approximate assessment as to the expectation of life. Vague guess-work is unacceptable in such circumstances. What the lawyers require is a precise and dogmatic answer.

"Why are there no effective treatments for my condition? Why do researchers exclude patients with primary progressive multiple sclerosis from enrolling in clinical trials? Please let me know if you hear of studies that I might be allowed to enter or treatments that I could try for my condition. " Thus, in recent years, the sad lament of the patient with primary progressive MS (PPMS). This variant, often in the guise of a chronic progressive myelopathy or, less commonly, progressive cerebellar or bulbar dysfunction, usually responds poorly to corticosteroids and rarely seems to benefit to a significant degree from intensive immunosuppressive treatments. In recent years, most randomized clin ical trials have excluded PPMS patients on two counts. Clinical worsening devel ops slowly in PPMS and may not be recognized during the course of a 2-or 3-year trial even in untreated control patients. This factor alone adds to the potential for a type 2 error or, at the very least, inflates the sample size and duration of the trial. In addition, there is mounting evidence that progressive axonal degeneration and neuronal loss (rather than active, recurrent inflammation) may be important components of the pathology in this form of the disease. Although contemporary trials are evaluating whether PPMS patients may benefit from treatment with the ~-interferons and glatiramer acetate, preliminary, uncontrolled clinical experi ence suggests that the results may not be dramatic.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.

The book presents a basis for the interaction of the brain and nervous system with painting, music and literature, and a discussion of art from multiple facets – such as anatomy, migraine, illusion and evolutionary biology. The book explores several aspects of the neurobiology of painting, including evolutionary neurobiology, sensation vs. perception, the visual brain and how the mind works, and also explores the affects of brain disorders and trauma on artist, with a concluding chapter on Frida Kahlo and the spinal cord injury that influenced her painting.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.

This is the first book to comprehensively address neurodiagnostic testing for the broad scope of clinical neurophysiologic disorders in the pediatric population. The field of clinical neurophysiology has expanded exponentially with the development of new approaches, techniques, studies, and certifications. This book bridges the gap in clinical information available for practitioners who use neurophysiologic techniques to evaluate and treat children and adolescents with epilepsy, sleep, neuromuscular, and autonomic disorders but may not have subspecialty training in each individual field. Drawing on the expertise and clinical wisdom of leading practitioners and researchers in each area of clinical neurophysiology, the book focuses on the technical and interpretive skills unique to treating the pediatric population. It covers the full spectrum of neurophysiologic topics including pediatric sleep disorders, epilepsy, febrile seizures and nonepileptic paraxosysmal disorders. Chapters address pediatric muscular dystrophies, EMG, brachial plexopathies, peripheral neuropathy, intraoperative monitoring, evoked potentials, evaluation of autonomic disorders, and EMG studies for all applications. This singular working reference will be indispensable for the clinical provider as well as for trainees and technologists who use a wide diversity of clinical neurophysiologic skills to more accurately diagnose and treat neurologic disorders in children and adolescents. Key Features: Delivers comprehensive information on all areas of pediatric clinical neurophysiology Provides clinical and procedural guidance for performing and interpreting neurodiagnostic tests in children and adolescents Over 100 illustrations of studies and findings amplify the text Brings together experts from the fields of epilepsy, sleep, neuromuscular and autonomic disorders, and neurophysiological monitoring About the Editor: Gloria M. Galloway, MD, FAAN is Professor of Clinical Neurology, Ohio State University Medical Center, Columbus, OH