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which the EEG abnormalities are less regularly of a 3-per-second spike-and-wave type (they may occur at the rate of 2 to 25 per second or take the form of 4- to 6-Hz polyspike-and-wave complexes) Atypical petit mal is a term that was coined to describe long runs of slow spike-and-wave activity, usually with no apparent loss of consciousness External stimuli such as asking the patient to answer a question or to count will interrupt the run of abnormal EEG activity About one-third of children with absence attacks will, in addition, display symmetrical or asymmetrical myoclonic jerks without loss of consciousness, and about half will also at some time have major generalized (tonic-clonic) convulsions As described further on, a common and relatively benign variety of myoclonic seizure occurs in late childhood and adolescence (juvenile myoclonic epilepsy) In sharp contrast to the aforementioned epilepsies is a form that has its onset between 2 and 6 years of age and is characterized by atonic, or astatic, seizures (ie, falling attacks), often succeeded by various combinations of minor motor, tonic-clonic, and partial seizures and by progressive intellectual impairment in association with a distinctive, slow (1- to 2-Hz) spike-and-wave EEG pattern This is the Lennox-Gastaut syndrome Often it is preceded in earlier life by infantile spasms, a characteristic EEG picture (3-Hz hypsarrhythmia ), and an arrest in mental development, a triad sometimes referred to as the West syndrome (see further on) The early onset of atonic seizures with abrupt falls, injuries, and associated abnormalities nearly always has a grave implication namely, the presence of serious neurologic disease Prematurity, perinatal injury, and metabolic diseases of infancy are the most common underlying conditions This is essentially a symptomatic generalized epilepsy, in contrast to the foregoing idiopathic types The LennoxGastaut syndrome may persist into adult life and is one of the most dif cult forms of epilepsy to treat The notion that absence, myoclonic, and akinetic seizures constitute a petit mal triad, as originally proposed by Lennox, has been generally abandoned Akinesia (motionlessness) is not unique to any seizure type The typical absence, with or without myoclonic jerks, rarely causes the patient to fall and should be considered a separate entity because of its relative benignity.

When dealing with processors from the Pentium family, it is not difficult to determine how much memory you need to create a full bank, since they are all 64-bit processors However, you might have to work with older processors and older types of RAM Use the formula in Exercise 5-2 to figure out the number of memory modules you need to install in your computer

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The phenomenon of myoclonus has already been discussed in Chap 6, where the relationship to seizures was indicated Characterized by a brusque, brief, muscular contraction, some myoclonic jerks are so small as to involve only one muscle or part of a muscle; others are so large as to implicate a limb on one or both sides of the body or the entire trunk musculature Many are brief, lasting 50 to 100 ms They may occur intermittently and unpredictably or present as a single jerk or a brief salvo As mentioned earlier, an outbreak of several small, rhythmic myoclonic jerks may appear with varying frequency as part of absence seizures and as isolated events in patients with generalized clonic-tonic-clonic or tonic-clonic seizures As a rule, these types of myoclonus are quite benign and respond well to medication In contrast, disseminated myoclonus (polymyoclonus), having its onset in childhood, raises the suspicion of acute viral encephalitis, the myoclonus-opsoclonus-ataxia syndrome of Kinsbourne, lithium or other drug toxicity, or, if lasting a few weeks, subacute sclerosing panencephalitis Chronic progressive polymyoclonus with dementia characterizes the group of juvenile lipidosis, Lafora-

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Oracle RMAN can run from one database server and up to all the available database servers in the Database Machine RAC cluster The number of nodes that you allocate to run RMAN depends on whether adding more RMAN clients will increase the total throughput of the backup You can also tune the throughput by increasing the number of channels allocated to each RMAN process

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