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By T. Hector. Golden State Baptist College.

Journal of Neurology buy cheap buspar 5 mg on line, Neurosurgery and Psychiatry 2002; 73: 215 (abstract 10) Cross References Dystonia; Torticollis Gibbus Angulation of the spine due to vertebral collapse may be due to osteo- porosis purchase 5mg buspar with visa, metastatic disease purchase buspar 10 mg amex, or spinal tuberculosis 10mg buspar with amex. Cross References Camptocormia; Myelopathy Girdle Sensation Compressive lower cervical or upper thoracic myelopathy may pro- duce spastic paraparesis with a false-localizing mid-thoracic sensory level or “girdle sensation” (cf. The pathophysiology is uncer- tain, but ischemia of the thoracic watershed zone of the anterior spinal artery from compression at the cervical level has been suggested. References Ochiai H, Yamakawa Y, Minato S, Nakahara K, Nakano S, Wakisaka S. Clinical features of the localized girdle sensation of mid-trunk (false localizing sign) appeared [sic] in cervical compressive myelopathy patients. Journal of Neurology 2002; 249: 549-553 Cross References “false-localizing signs”; Paraparesis; Suspended sensory loss “Give-Way” Weakness - see COLLAPSING WEAKNESS; FUNCTIONAL WEAKNESS AND SENSORY DISTURBANCE Glabellar Tap Reflex The glabellar tap reflex, also known as Myerson’s sign or the nasopalpebral reflex, is elicited by repeated gentle tapping with a finger on the forehead, preferably with irregular cadence and so that the patient cannot see the finger (to avoid blinking due to the threat or menace reflex), while observing the eyelids blink (i. Usually, reflexive blinking in response to tapping habituates quickly, but in extrapyramidal disorders it may not do so. This sign was once thought useful for the diagnosis of idiopathic Parkinson’s disease but in fact it is fairly nonspecific, occurring in many akinetic-rigid disorders. Journal of Neurology, Neurosurgery and Psychiatry 2003; 74: 558-560 Cross References Blink reflex; Parkinsonism - 137 - G Glossolalia Glossolalia Glossolalia, or speaking in tongues, may be considered a normal phe- nomenon in certain Christian denominations, as divinely inspired, since it is mentioned in the Bible (1 Corinthians, 14:27-33, although St. Paul speaks of the importance of an interpreter, since “God is not the author of confusion”), but it is not confined to Christianity or even overtly religious environments. Others conceptualize glossolalia as a form of automatic speech, usually of a pseudo-language which may be mistaken for a foreign tongue. Such happenings may occur in trance- like states, or in pathological states, such as schizophrenia. London: Arnold, 2001: 237-240 “Glove and Stocking” Sensory Loss Sensory loss, to all or selected modalities, confined to the distal parts of the limbs (“glove and stocking”) implies the presence of a periph- eral sensory neuropathy. If the neuropathy involves both sensory and motor fibers, motor signs (distal weakness, reflex diminution or loss) may also be present. Cross References Neuropathy Goosebumps - see ANSERINA Gordon’s Sign Gordon’s sign is an extensor plantar response in response to squeezing the calf muscles, also called the paradoxical flexor response. As with Chaddock’s sign and Oppenheim’s sign, this reflects an expansion of the receptive field of the reflex. Cross References Babinski’s sign (1); Plantar response Gowers’ Sign Gowers’ sign is a characteristic maneuver used by patients with proxi- mal lower limb and trunk weakness to rise from the ground. From the lying position, the patient rolls to the kneeling position, pushes on the ground with extended forearms to lift the hips and straighten the legs, so forming a triangle with the hips at the apex with hands and feet on the floor forming the base (known in North America as the “butt-first maneuver”). Then the hands are used to push on the knees and so lift up the trunk (“climbing up oneself”). This sign was originally described by Gowers in the context of Duchenne muscular dystrophy but may be seen in other causes of proximal leg and trunk weakness, e. Gowers was not the first to describe the sign; Bell had reported it almost 50 years before Gowers’ account. London: Imperial College Press, 2003: 378-380 Graefe’s Sign - see VON GRAEFE’S SIGN Graphanesthesia - see AGRAPHESTHESIA Graphesthesia Graphesthesia is the ability to identify numbers or letters written or traced on the skin, first described by Head in 1920. Loss of this ability (agraphesthesia, dysgraphesthesia, or graphanesthesia; sometimes referred to as agraphognosia) is typically observed with parietal lobe lesions, for example in conditions such as corticobasal degeneration. Such a cortical sensory syndrome may also cause astereognosis and impaired two-point discrimination. Cross References Agraphesthesia; Astereognosis; Two-point discrimination Graphospasm - see WRITER’S CRAMP Grasp Reflex The grasp reflex consists of progressive forced closure of the hand (contraction of flexor and adductor muscles) when tactile stimulation (e. Once established, the patient is unable to release the grip (forced grasping), allowing the examiner to draw the arm away from the patient’s body. There may also be accom- panying groping movements of the hand, once touched, in search of the examiner’s hand or clothing (forced groping, magnetic movement). Although categorized a reflex, it may sometimes be accessible to mod- ification by will (so-called alien grasp reflex). The grasp reflex may be categorized as a frontal release sign (or primitive reflex) of prehensile type, since it is most commonly associ- ated with lesion(s) in the frontal lobes or deep nuclei and subcortical white matter. Clinicoradiological correlations suggest the cingulate gyrus is the structure most commonly involved, followed by the supplementary motor area. The incidence of the grasp reflex following hemispheric lesion and its relation to frontal damage.

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Personal goals – do you want your work published within a certain year or in a particular quarterly journal? This will give you a very firm tar­ get to work towards buspar 5mg with visa, but you must make sure that it is a realistic goal buy buspar 10mg with amex. Writing style – you will need to estimate how long you personally need to complete the task purchase buspar 10 mg without a prescription. This might be in short discount 5 mg buspar visa, inten­ sive bursts or at a slow, steady pace over a longer period of time. Do you need to research background information, or do you have most of your data ready? You may need to allow for a longer period of time for researching your material. A manuscript of 120,000 words requires a very different timescale to a smaller project of 60,000 words. Prob­ lems can arise if different writing styles have not been addressed in the planning stage. The timetable should meet the needs of each individual, and this often means going with the lowest common denominator. There is no point one person racing ahead if the other author is still methodically 238 WRITING SKILLS IN PRACTICE but slowly working through his or her own work. Remember to include additional slots for meetings, sharing work, joint planning and editing sessions. Other considerations – major events, whether personal, social or work, need to be taken into account. Allow for time out for such things as major business trips, family weddings or planned hospital treatment. You are now ready to make an estimate of how much time you will need to complete each stage. Work backwards from your finish date and mark in completion dates for each stage on your plan. Remember that it is commonplace for articles for peer-reviewed journals to be returned for re­ drafting, and editors may return your chapter or book with queries or cor­ rections requiring your attention. These factors need to be taken into consideration when planning your schedule. Setting up a timetable Use your planner to draw up a timetable that includes weekly or monthly schedules covering your intended timeframe. Block out time committed to non-writing activities like work, shopping, a hobby or family activities like taking the children swimming. Remember to include one-off events like weddings, holidays or work situations such as attending a major con­ ference. Draw your timetable large enough so that there is space to write in daily goals. Use your planning sheet to mark the completion dates for your subgoals, main goals and stages on the timetable. If you find that one of your completion dates coincides with a major event, then reschedule it. Planning individual sessions You are now ready to start drawing up plans for your writing slots. It might be to complete a database search, or to find out what books are available on a specific subject. However, without any specific goals about what you do when you get there, you will be un­ able to gauge how much further on you are in your work schedule. MANAGING YOUR TIME EFFECTIVELY 239 You may want to break tasks down into different categories. Try the following: ° planning ° writing ° research ° telephone calls ° letters ° jobs. You may find it useful to divide your session plan into smaller squares that represent these categories. Once you know what you want to do in the session, you can start thinking about the best order in which to do things. Arrange tasks in order of priority, starting with items that must be done in that session.

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