Proton therapy does not appear to reduce OAR volumes receiving high dose. Protons are able to reduce the treated volume receiving low-intermediate doses, however the clinical significance of this remains to be determined in future investigations.

Studies of the relationship of clinical and laboratory measures of accommodation and convergence function with refractive error are reviewed. There are inconsistencies in results from study to study presumably due, in part, to methodological differences. However, some basic trends can be outlined. In studies in young adults, accommodation in darkness (dark focus), optical reflex accommodation, and proximally induced accommodation are less in myopes than in emmetropes and hyperopes. It also appears that nearpoint esophoria is associated with higher rates of myopia progression in children. Implications for myopia etiology are discussed.

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Pencil-beam scanning PBT is clinically feasible and can be robustly delivered for anal cancer patients. Compared with IMRT, PBT reduces low dose radiation to important organs at risk in this population. While the clinical benefit of these differences remains to be shown, existing data suggest that limiting low dose to the small bowel and pelvic bone marrow may reduce treatment toxicity.

Summary:Purpose: We sought to determine whether hypersalivation helps lateralize seizure onset during complex partial seizures of temporal lobe origin. Several clinical signs, which help lateralize seizure onset, have been reported in temporal lobe epilepsy (TLE). Increased salivation only occasionally has been reported as a manifestation of partial epilepsy.Methods: Of 590 consecutive patients admitted for video-EEG monitoring, either as a part of a presurgical evaluation of medically intractable epilepsy or for diagnosis and clarification of their paroxysmal symptoms, we identified 10 patients with ictal hypersalivation as a prominent manifestation of complex partial seizures. We reviewed the clinical features, scalp-sphenoidal video-EEG monitoring, intracarotid amytal (Wada) testing, hippocampal volumetric magnetic resonance imaging (MRI), and fluorodeoxyglucose-positron emission tomography (FDG-PET) scans of these patients. Results:Of the 10 patients with ictal hypersalivation, seven patients had nondominant/right TLE, and three patients had dominant/left TLE. All patients had hippocampal atrophy on volumetric MRI. Eight of the 10 patients underwent standard temporal lobectomy with amygdalohippocampectomy (six right, two left). All of the operated-on patients had a seizure-free (Engel class I) outcome, and their increased salivation resolved. Two patients, who did not undergo surgical treatment, continue to have complex partial seizures with increased salivation.Conclusions: We conclude that increased salivation as a prominent ictal finding in complex partial seizures of temporal lobe origin is more likely to be of nondominant temporal lobe origin. Further studies with larger numbers of patients are needed to replicate this finding. Key Words: Temporal lobe epilepsyComplex partial seizure-Hypersalivation-Video-EEG monitoring.Autonomic and visceral manifestations are common during epileptic seizures and are usually associated with impaired consciousness. Autonomic nervous system involvement in partial seizures of temporal lobe origin manifests as change in blood pressure, heart rate, cardiac rhythm, chest pain, sudden death, respiratory changes, flushing, pallor, piloerection, diaphoresis, mydriasis, miosis, abdominal pain, epigastric rising sensation, nausea/vomiting, bloating, diarrhea, stridor, choking, and coughing (1).Salivary secretion is under neural control. Stimulation of the parasympathetic nerve supply of the salivary glands results in profuse secretion of watery saliva, with relatively low content of organic material; whereas stimulation of the sympathetic nerve supply causes secretion of a small amount of saliva rich in organic constituents. Food in the mouth, stimulation of vagal afferent fibers at the gastric end of the esophagus, sight, smell, and even the thought of food can cause salivary secretion (2).We describe the clinical features, scalp-sphenoidal video-EEG monitoring, magnetic resonance imaging METHODSWe reviewed 590 consecutive patients who were evaluated by using prolonged video-mo...