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Development of main d’accoucheur within 4 minutes of inflation of a sphygmomanometer cuff above arterial pres- sure (Trousseau’s sign) indicates latent tetany. Mechanosensitivity of nerves may also be present elsewhere (Chvostek’s sign). Cross References Chvostek’s sign; Trousseau’s sign Main en Griffe - see CLAW HAND Main Étranger - see ALIEN HAND, ALIEN LIMB Main Succulente Main succulente refers to a swollen hand with thickened subcutaneous tissues, hyperkeratosis and cyanosis, trophic changes which may be observed in an analgesic hand, e. Cross References Charcot joint “Man-in-a-Barrel” “Man-in-a-barrel” is a clinical syndrome of brachial diplegia with preserved muscle strength in the legs. Acute central cervical cord lesions may also produce a “man-in-a-barrel” syndrome, for example after severe hyperextension injury, or after unilateral vertebral artery dissec- tion causing anterior cervical spinal cord infarction. This may follow a transient quadriplegia, and considerable recovery is possible. A neuro- genic main-in-a-barrel syndrome has been reported (“flail arm syn- drome”), which is a variant of motor neurone disease. Neurology 1969; 19: 279 (abstract GS7) Cross References Flail arm; Quadriparesis, Quadriplegia Marche à Petit Pas Marche à petit pas is a disorder of gait characterized by impairments of balance, gait ignition, and locomotion. Particularly there is short- ened stride (literally marche à petit pas) and a variably wide base. This gait disorder is often associated with dementia, frontal release signs, and urinary incontinence, and sometimes with apraxia, parkinsonism, and pyramidal signs. This constellation of clinical signs reflects under- lying pathology in the frontal lobe and subjacent white matter, most usually of vascular origin. Modern clinical classifications of gait dis- orders have subsumed marche à petit pas into the category of frontal gait disorder. Human walking and higher- level gait disorders, particularly in the elderly. Neurology 1993; 43: 268-279 Cross References Apraxia; Dementia; Frontal release signs; Parkinsonism Marcus Gunn Phenomenon - see JAW WINKING Marcus Gunn Pupil, Marcus Gunn Sign The Marcus Gunn pupil or sign, first described in 1902, is the adapta- tion of the pupillary light reflex to persistent light stimulation, that is, a dilatation of the pupil is observed with continuing stimulation with incident light (“dynamic anisocoria”). This is indicative of an afferent pathway defect, such as retrobulbar neuritis. Normally the responses are equal but in the presence of an afferent conduction defect an inequality is manifest as pupillary dilatation. Cross References Pupillary reflexes; Relative afferent pupillary defect (RAPD); Swinging flashlight sign Mask-like Facies The poverty of spontaneous facial expression, hypomimia, seen in extrapyramidal disorders, such as idiopathic Parkinson’s disease, is sometimes described as mask-like.

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Fasim, 48 years: Writing Police Statements Police statements can be exciting at first, but soon become tiresome when you are handed cases by the basket. Table 2 Risk Factors for Febrile Seizures and Epilepsy Febrile seizures Epilepsy Young age of onset Neurodevelopmental abnormality Family history of febrile seizures Family history of epilepsy Low temperature at occurrence Complex febrile seizures Short duration of fever Short duration of fever Number of febrile seizures 78 Shinnar Febrile Seizures and Mesial Temporal Sclerosis. Since then, hundreds of thousands of Bacteria and bacterial infection; Bacteriophage and bacterio- people have successfully received organ transplants, where phage typing; Blood agar, hemolysis, and hemolytic reactions; none would have before the discovery of cyclosporin.

Domenik, 39 years: Colles worked with unflagging energy at Colles returned to Dublin towards the end of Steevens’ Hospital and soon became recognized the year 1797 and became attached to the Sick as an able surgeon. The resident staff includes sur- children, perhaps as many as eight, in various forms of geons from England, Scotland, Ireland, Wales, splints. Early follow-up series confirmed the very low incidence of postoperative thigh pain in the cementless Bicontact implantations with comparable results to the cemented stems of similar, uncoated design.

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