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Sumatriptan for headache, 159 for migraine, 154 Summation theory of pain, 111 Sundowning, 303 Sunset sign, 240 Superior sagittal sinus thrombophlebitis, septic, 605 606 Superior thoracic aperture syndrome, 183, 186 188 Superoxide dismutase, 943 Supplementary motor area, 44 Supranuclear palsy, 222 Suprascapular nerve, mononeuropathy of, 1167, 1167t Suprasellar germinomas, 569 Surgery. See also speci c procedures ablative, for pain, 126 confusion following, 363 364, 710 711 epilepsy, 298 Susac syndrome, 733 Swallowing, 475 477 anatomy and physiology of, 476 Sweating, disorders of, 466 467 Swing phase of gait cycle, 100, 101f Sydenham chorea, 64t, 65 Sylvian epilepsy, 279 Sympathectomy, thoracolumbar, 466 Sympathetic apraxia, 49 Sympathetic nervous system anatomy of, 453, 453f, 455f, 455 456, 456f primary failure of, syncope and, 326 327 Sympathetic skin-resistance test, 461 Sympathetic storm, 465 466 Sympathetic system, hypothalamic regulation of, 457 Synaptic vesicles, paucity of, 1260t Syncope, 322 331 cardiac, 323, 327 328 carotid sinus, 323 with cerebrovascular disease, 328 clinical features of, 322 323 convulsive, 322 differential diagnosis of, 328 329 examination in, 329 330 neurogenic, 324 326 carotid sinus, 325 deglutitional, 326 exercise-induced, 325 with glossopharyngeal neuralgia, 325 326 micturition, 326 neurocardiogenic, 324 325 tussive, 326 Valsalva, 326

2x 1 2x 1 4x2 4x 1 4x2 2x 2x 1 4x2 4x 1 4x 1 4x 1 The last equation is true for any real number x. An equation true for any real number x is called an identity. So, 2x 1 2 4x2 4x 1 is an identity. p 7x 1 13 hp i2 7x 1 132 7x 1 169 1 1 7x 168 168 x 7 x 24 9: p x 6 10 p x 6 10 Isolate the square root bef ore 6 6 squaring both sides. p x 16 p 2 x 162 x 256 p 2x 3 1 6 p Isolate the square root bef ore 2x 3 1 6 1 1 squaring both sides. p 2x 3 5 hp i2 2x 3 52 2x 3 25 3 3 2x 28 28 x 2 x 14

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The bedside analysis of aphasic disorders that we nd most useful entails the systematic testing of six aspects of language function: conversational speech, comprehension, repetition, reading, writing, and naming Simply engaging the patient in conversation permits assessment of the motor aspects of speech (praxis and prosody), uency, and language formulation If the disability consists mainly of sparse, laborious, non uent speech, it suggests, of course, Broca s aphasia, and this possibility can be pursued further by tests of repeating from dictation and by special tests of praxis of the oropharyngeal muscles Fluent but empty paraphasic speech with impaired comprehension is indicative of Wernicke s aphasia Impaired comprehension but perfectly normal formulated speech and intact ability to read suggest the rare syndrome of pure worddeafness When conversation discloses virtually no abnormalities, other tests may still be revealing The most important of these are reading, writing, repetition, and naming.

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Reading aloud single letters, words, and text may disclose the dissociative syndrome of pure word-blindness Except for this syndrome and pure word mutism (see above), writing is disturbed in all forms of aphasia Literal and verbal paraphasic errors may appear in milder cases of Wernicke s aphasia as the patient reads aloud from a text or from words in the examiner s handwriting Similar errors appear even more frequently when the patient is asked to explain the text, read aloud, or give an explanation in writing Testing the patient s ability to repeat spoken language is a simple and important maneuver in the evaluation of aphasic disorders As with other tests of aphasia, it may be necessary to increase the complexity of the test from digits and simple words to complex words, phrases, and sentences in order to disclose the full disability.

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tional system Luria found that when the frontal lobes are injured by disease, there was not only a general psychomotor slowing and easy distractibility but also an erroneous analysis of the abovelisted conditions of the problem The plan of action that is selected quickly loses its regulating in uence on behavior as a whole and is replaced by a perseveration of one particular link of the motor act or by the in uence of some connection established during the patient s past experience Furthermore, there was a failure to distinguish the essential sequences in the analysis and to compare the nal solution with the original conception of the problem Plausible as this scheme appears, like Goldstein s loss of the abstract attitude (the patient thinks concretely, ie.

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