We report two cases of ictal vomiting in patients who had left temporal lobe epilepsy. In one patient, vomiting developed when the discharge spread to the right temporal lobe as seen during depth electrode recording. In the second patient, ictal vomiting occurred with a restricted left temporal discharge, but the patient was left-handed and had right-hemisphere language dominance. These cases provide additional evidence of the involvement of the nondominant temporal lobe in ictus emeticus.
Conditioning methodologies associated with the psychology of learning are suggested as a new strategy to investigate behavior of the assassin bug Rhodnius prolixus, which is the main vector of Chagas disease in Venezuela. Chagas disease is the fourth leading cause of death in Latin America, as it causes severe chronic illness and approximately 43,000 deaths per year. To illustrate this strategy, two preliminary experiments are reported. In the first, Pavlovian conditioning was examined by pairing an olfactory conditioned stimulus with a temperature unconditioned stimulus. A temperature of 42 degrees C elicits a complex behavioral sequence in R. prolixus consisting of proboscis extension and crawling. Over the course of 12 training trials, this behavioral sequence was not elicited by an olfactory conditioned stimulus. In the second experiment, a latent inhibition paradigm was used to pre-expose R. prolixus to an olfactory conditioned stimulus before pairing the odor with temperature. Over the course of training, an effect of pre-exposure was found. Suggestions for research are discussed and potential conditioned and unconditioned stimuli identified.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is characterised by significant clinical heterogeneity and as such reliable biomarkers are required to measure disease activity and assess treatment response. Recent advances in our understanding of disease pathogenesis and the discovery of novel serum-based, electrophysiologic and imaging biomarkers allow clinicians to make more informed decisions regarding individualised treatment regimes.As a chronic immune-mediated process typified by relapse following withdrawal of immunomodulatory therapy, a substantial proportion of patients with CIDP require long term treatment with intravenous immunoglobulin (IVIg), a scarce and expensive donor-derived resource. The required duration and intensity of immunoglobulin treatment vary widely between individuals, highlighting both the heterogeneous nature of the underlying disease process as well as the variable pharmacologic properties of IVIg.This review outlines the use of multimodal biomarkers in the longitudinal evaluation of nerve injury and how recent developments have impacted our ability to predict both response to immunoglobulin administration and its withdrawal.
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