Brain : a journal of neurology
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Eleven patients with static or slowly progressive multiple sclerosis were treated with continuous spinal cord stimulation via epidural electrodes for a minimum of two weeks. An extensive battery of objective tests was used to assess results. ⋯ Five additional patients selected for these disabilities were then treated with further evidence of improvement in bladder function in 4 and in lower limb spasticity in 2. It is suggested that benefit results from inhibition of excessive spinal reflex activity.
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Thirteen patients with transient or permanent homonymous visual field defects experienced formed hallucinations localized to the affected part of the visual field. The lesion was occipital in 8 instances (infarction 7, porencephalic cyst 1), parietooccipital in 3 (infarction 2, angioma 1) and probably parietal in 2 (epilepsy 1, encephalitis 1). The disorder involved the right hemisphere in 9 cases, the left hemisphere in 3 cases and both hemispheres sequentially in one patient. ⋯ In most cases, the hallucinations were not clearly related to any visual memory. It is suggested that the visual association cortex amy be responsible for the organization of visual percepts into broad categories of which people, animals and objects are representative. The occurrence of such hallucinations with a visual field defect suggests that the cells of the association cortex are more likely to discharge spontaneously once they are deprived of their normal afferent inflow from the calcarine cortex.