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urane, halothane and nitrous oxide in status epilepticus Ann Neurol 19: 98, 1986 SALANOVA V, ANDERMANN F, RASMUSSEN T, et al: Parietal lobe epilepsy Clinical manifestations and outcome in 82 patients treated surgically between 1929 and 1988 Brain 118:607, 1995 SCHEIBEL ME, SCHEIBEL AB: Hippocampal pathology in temporal lobe epilepsy: A Golgi survey, in Brazier MAB (ed): Epilepsy: Its Phenomena in Man New York, Academic Press, 1973, pp 315 357 SCHOMER DL: Partial epilepsy N Engl J Med 309:536, 1983 SPECCHIO LM, TRAMACERE L, LANEVE A, BEGHI E: Discontinuing antiepileptic drugs in patients who are seizure-free on monotherapy J Neurol Neurosurg Psychiatry 72:22, 2002 STEINLEIN OK: Genes and mutations in idiopathic epilepsy Am J Med Genet 106:139 145, 2002 SUNG C, CHU N: Status epilepticus in the elderly: Aetiology, seizure type and outcome Acta Neurol Scand 80:51, 1989 SUTULA TP, PITKANEN A: More evidence for seziure-induced neuron loss Is hippocampal sclerosis both cause and effect of epilepsy Neurology 57:169, 2001 TAYLOR I, SCHEFFER IE, BERKOVIC SF: Occipital epilepsies: Identi cation of speci c and newly recognized syndromes Brain 126:753, 2003 THOMAS JE, REGAN TJ, KLASS DW: Epilepsia partialis continua: A review of 32 cases Arch Neurol 34:266, 1977 TODT H: The late prognosis of epilepsy in childhood: Results of a prospective follow-up study Epilepsia 25:137, 1984 TOWNE AR, MCGEE FE, MERCER EL, et al: Mortality in a communitybased status epilepticus study Neurology 40(suppl 1):229, 1990 TREIMAN DM, MEYERS PD, WALTON NY, et al: A comparison of four treatments for generalized status epilepticus N Engl J Med 339:792, 1998 TRIMBLE MR: Personality disturbance in epilepsy Neurology 33:1332, 1983 TRIMBLE MR, SCHMITZ B: The psychosis of epilepsy/schizophrenia, in Engel J Jr, Pedley TA (eds): Epilepsy: A Comprehensive Textbook Philadelphia, Lippincott-Raven, 1998, pp 2071 2081 TWYMAN RE, GAHRING LC, SPIESS J, ROGERS SW: Glutamate receptor antibodies activate a subset of receptors and reveal an agonist binding site Neuron 14:755, 1995 VICTOROFF J: DSM-III-R psychiatric diagnoses in candidates for epilepsy surgery: Lifetime prevalence Neuropsychiatry Neuropsychol Behav Neurol 7:87, 1994 VINING EP: The ketogenic diet Adv Exp Med Biol 497:225, 2002 VOLPE JJ: Neurology of the Newborn, 3rd ed Philadelphia, Saunders, 1995 WALDER B, TRAMER MR, SEECK M: Seizure-like phenomenna and propofol A systematic review Neurology 58:1327, 2002 WENDL H, BIEN CG, BERNASCONI P, et al: GluR3 antibodies: Prevalence in focal epilepsy but not speci c for Rasmussen s encephalitis Neurology 57:1511, 2001 WIEBE S, BLUME WT, GIRVIN JP, et al: A randomized, controlled trial of surgery for temporal-lobe epilepsy N Engl J Med 345:311, 2001 WYLIE E, LUDERS H, MORRIS HH, et al: The lateralizing signi cance of versive head and eye movements during epileptic seizures Neurology 36:606, 1212, 1986 YOON HH, KWON HL, MATTSON RH: Long-term seizure outcome in patients initially seizure-free after resective epilepsy surgery Neurology 61:445, 2003 ZEMAN AZ, BONIFACE SJ, HODGES JR: Transient epileptic amnesia: A description of the clinical and neuropsychological features in 10 cases and a review of the literature J Neurol Neurosurg Psychiatry 64:435, 1998.

Figure 44-2 MRI of spinal epidural abscess compressing the dorsolateral cervical cord T-1 gadoliniumenhanced images Sagittal (left) and axial (right) images The pyogenic collection enhances at the periphery and extends over several segments The pyogenic collection is shown by the arrows

diagnosis or inadequate therapy, may evolve into a local chronic adhesive meningomyelitis Subacute pyogenic infections and granulomatous infections (tuberculous, fungal) may also arise in the spinal epidural space, as noted below Spinal Cord Abscess This entity was rst described by Hart in 1830 and, although it is rare, 73 cases had been reported by 1994 (Candon and Frerebeau) In some instances the patient was known to have had systemic bacterial infection, septicemia, or endocarditis; in others there was a contiguous abscess in the skin or subcutaneous tissues with a stula to the spinal cord through an intervertebral foramen Spinal cord abscess is a rare complication of spinal dysraphism or of a developmentally open stulous tract The symptoms are indistinguishable from those of epidural abscess namely, spinal and radicular pain followed by sensory and motor paralysis; the CSF ndings are also the same Woltman and Adson described a patient in whom surgical drainage of an encapsulated intramedullary abscess led to recovery, and Morrison and associates reported a similar case caused by Listeria monocytogenes, which was successfully drained and the meningeal infection suppressed by ampicillin and chloramphenicol MRI is the most useful diagnostic procedure Tuberculous Spinal Osteomyelitis (Pott disease) Tuberculous osteitis of the spine with kyphosis (Pott disease) is well known in regions of endemic tuberculosis Children and young adults are most often affected The osteomyelitis is the result of reactivation of tuberculosis at a site previously established by hematogenous spread An infectious endarteritis causes bone necrosis and collapse of a thoracic or upper lumbar (less often cervical) vertebral body resulting in a highly characteristic angulated kyphotic deformity

(Fig 44-3); any degree of additional rotary instability produces a gibbus deformity Most patients have some evidence of active infection as evidenced by fever, night sweats, and other consitutional symptoms; the sedimentaion rate is invariably elevated A compressive myelopathy occurs in some cases as a result of the spinal deformity, but it is surprisingly infrequent and an epidural tuberculous abscess is a more common cause of cord compression (see below) What is surprising to us about Pott disease is the excellent result that may be obtained by external stabilization of the spine and long-term antituberculous medication While there is some controversy regarding spinal surgery, it is required only in the presence of severe deformities or a compressive myelopathy Tuberculous Myelitis Solitary tuberculoma of the spinal cord as part of a generalized infection is an extreme rarity More often, pus or caseous granulation tissue may extrude from an infected vertebra and gives rise to an epidural compression of the cord (Pott paraplegia, as distinct from Pott disease) Occasionally a tuberculous meningitis may result in pial arteritis and spinal cord infarction The paraplegia may appear before the tuberculous meningitis is diagnosed All these forms of tuberculosis have become infrequent in the United States and western Europe but we see a new case every several years in patients who spent their earlier life in India or Africa Additional comments can be found on page 611 Meningomyelitis due to Fungus and Parasitic Diseases A wide variety of fungal and parasitic agents may involve the spinal meninges Such infections are rare, and some do not occur at all in the United States or are limited to certain geographic areas, particularly among immigrant populations Actinomyces, Blastomyces, Coccidioides, and Aspergillus may invade the spinal epidural space via intervertebral foramina or by extension from a vertebral osteo-

Let s start with the column chart We can take the original chart and work with it We know that the data is consistent and correct, which is about 70 percent of the battle If the data is being displayed in the chart and showing the correct information, we can then work with the format and see if we can revamp it to make it more appealing and dynamic You can use quick and simple settings to improve the standard display for column charts First, let s adjust the shape from a one-dimensional object to a 2D object and adjust from a rectangle to a cylinder, as shown next To adjust to a 2D, just click on the 2D feature in the wizard first step Once this is finished we will continue the formatting in the Chart Designer component of the wizard This makes it more dynamic and jump out of the screen at the audience

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