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An example of a mixture of characters and letters that have to be in a given sequence is a social security number, or in the UK, a National Insurance number. A coded sequence for this format string would be

With hemispheric lesions, the eyes are often turned away from the paralyzed side (toward the lesion, as described below); the opposite may occur with brainstem lesions In most cases, a hemiplegia and an accompanying Babinski sign are indicative of a contralateral hemispheral lesion; but with lateral mass effect and compression of the opposite cerebral peduncle against the tentorium, extensor rigidity, a Babinski sign, and weakness of arm and leg may also occur ipsilateral to the lesion (the above described Kernohan-Woltman sign) A moan or grimace may be provoked by painful stimuli on one side but not on the other, re ecting the presence of a hemianesthesia; also during grimacing, facial weakness may be noted Of the various indicators of brainstem function, the most useful are pupillary size and reactivity, ocular movements, oculovestibular re exes, and, to a lesser extent, the pattern of breathing.

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As remarked in Chap 24, the term depression embraces more than a feeling of sadness and unhappiness It stands for a complex of disturbed feelings (called mood, or affective, disorder) which may include despair, hopelessness, sense of worthlessness, and thoughts of self-harm associated with decreased energy and libido, loss of interest in personal affairs, impaired concentration, various abnormalities of behavior and appearance, and prominent physical complaints the most important of which are insomnia, anorexia or overeating, headache, and various types of regional pain At one extreme are depressive symptoms of psychotic proportions (including paranoid or somatic delusions), which create chaos in the lives of the patient and those close to him.

At the other extreme are the common feelings of unhappiness, anhedonia (loss of pleasurable responses), discouragement, and resentment that occur in almost everyone as a reaction to the disappointments of everyday life, such as loss of employment, a failure to gain recognition, or unsuccessful sexual or social adjustment, all of which are closely linked in their duration to the persistence of the precipitant factors The place in this nosology of postpartum depression has not been clear as discussed in the next chapter In severe cases it is sometimes dif cult to differentiate this condition from postpartum psychosis, a more dramatic and well-de ned disorder discussed in the next chapter Many modern authors question the existence of a primary biologic depression that is tied to the postpartum period (see summary by Brockington).

This is not in accord with general experience in which varying degrees of depression are quite common in the weeks after delivery and cannot simply be attributed to psychosocial factors or sleep deprivation An abnormally elevated mood, or mania, is about one third as frequent as depression It may develop as a relatively pure, recurrent clinical state, or it may alternate or be intertwined with depression, in which case it has been referred to as manic-depressive disease (bipolar disorder in the classi cation of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV) Hypomania and cyclothymic disorder are the names given to milder forms of mania and bipolar disorder, respectively The DSM-IV classi cation also acknowledges the existence of mixed schizoaf-.

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The trace is not de ned unless its argument is square. The trace has several convenient properties: 1. T r A = T r(A),

These functions, like consciousness itself, are to a large extent dependent on the integrity of structures in the midbrain and rostral pons Pupillary Reactions These are of great diagnostic importance in the comatose patient A unilaterally enlarged pupil (55 mm diameter) is an early indicator of stretching or compression of the.

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Super cial peroneal n. (from common peroneal n.) Axillary n. (circumflex) Post cut. n. of arm (from radial n.) Lower Lat. cut. of arm (from radial n.) Iliohypogastric n. Inf. med. cluneal n. Inf. med. n. of thigh T2 3 4 5 6 7 8 9

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