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Barcode Control SDK supports generating Data Matrix, QR Code, PDF - 417 barcodes in RDLC Local Report using VB and C# class library both in ASP.NET and ... . function, is also predominantly the result of parietal lobe damage, and the relationship of the apraxias to language and to each other, exposes one of the most complicated issues in behavioral neurology The theoretical aspects of agnosia, particularly those related to the disturbances of visual processing, are discussed later in the chapter Cortical Sensory Syndromes The effects of a parietal lobe lesion on somatic sensation were rst described by Verger and then more completely by Dejerine, in his monograph L agnosie corti cale, and by Head and Holmes The latter, in their important paper of 1911, noted the close interrelationships between the thalamus and the sensory cortex As pointed out on page 133, the parietal postcentral cortical defect is essentially one of sensory discrimination, ie, an impairment or loss of the sense of position and passive movement and the ability to localize tactile, thermal, and noxious stimuli applied to the body surface; to distinguish objects by their size, shape, and texture (astereognosis); to recognize gures written on the skin; to distinguish between single and double contacts (two-point discrimination); and to detect the direction of movement of a tactile stimulus In contrast, the perception of pain, touch, pressure, vibratory stimuli, and thermal stimuli is relatively intact This type of sensory defect is sometimes referred to as cortical, although it can be produced just as well by lesions of the subcortical connections Clinicoanatomic studies indicate that parietocortical lesions that spare the postcentral gyrus produce only transient somatosensory changes or none at all (Corkin et al; Carmon and Benton) The question of bilateral sensory de cits as a result of lesions in only one postcentral convolution was raised by the studies of Semmes and of Corkin and their associates In tests of pressure sensitivity, two-point discrimination, point localization, position sense, and tactile object recognition, they found bilateral disturbances in nearly half of their patients with unilateral lesions, but the de cits were always more severe contralaterally and mainly in the hand These disturbances of discriminative sensation and the subject of tactile agnosia are discussed more fully in Chap 9 Dejerine and Mouzon described another parietal sensory syn drome in which touch, pressure, pain, thermal, vibratory, and position sense are all lost on one side of the body or in a limb This syndrome, more typically the result of a thalamic lesion, may also occur with large, acute lesions (infarcts, hemorrhages) in the central and subcortical white matter of the contralateral parietal lobe; in the latter case these symptoms recede in time, leaving more subtle defects in sensory discrimination Smaller lesions, particularly ones that result from a glancing blow to the skull or a small infarct or hemorrhage, may cause a defect in cutaneous-kinesthetic perception in a discrete part of a limb, eg, the ulnar or radial half of the hand and forearm; these cerebral lesions may mimic a peripheral nerve or root lesion (Dodge and Meirowsky) Also, a pseudothalamic pain syndrome on the side deprived of sensation by a parietal lesion has been described (Biemond) In a series of 12 such patients described by Michel and colleagues, burning or constrictive pain, identical to the thalamic pain syndrome (page 141), resulted from vascular lesions restricted to the cortex The discomfort involved the entire half of the body or matched the region of cortical hypesthesia; in a few cases the symptoms were paroxysmal Head and Holmes drew attention to a number of interesting points about patients with parietal sensory defects the easy fatigability of their sensory perceptions; the inconsistency of responses to painful and tactile stimuli; the dif culty in distinguishing more. NOTE C-level management refers to corporate positions whose titles begin with Chief CEO,
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