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We conducted a multicenter, double-blind, randomized, parallel, placebo-controlled trial in 190 patients to evaluate the safety and efficacy of three dosages of topiramate (600, 800, and 1,000 mg/day) as adjunctive therapy for patients with refractory partial epilepsy. During an 18-week double-blind treatment period, median percent reductions from baseline(More)
Situated learning theory offers a radical critique of cognitivist theories of learning, emphasizing the relational aspects of learning within communities of practice in contrast to the individualist assumptions of conventional theories. However, although many researchers have embraced the theoretical strength of situated learning theory, conceptual issues(More)
Although transient increases in heart rate typically occur, bradycardia has infrequently been noted in association with partial seizures. Five patients with temporal lobe epilepsy are described in whom sinus bradyarrhythmias and syncope were prominent manifestations of seizure activity. Partial improvement occurred in one of two patients in whom a permanent(More)
Management consultancy is seen by many as a key agent in the adoption of new management ideas and practices in organisations. Two contrasting views are dominant – consultants as innovators, bringing new knowledge to their clients, or as legitimating client knowledge. Those few studies which examine directly the flow of knowledge through consultancy in(More)
The authors describe a case of aspergillosis with carotid-cavernous sinus thrombosis diagnosed by use of magnetic resonance imaging (MRI). MRI may aid in early detection of intracranial fungal infection and potentially help decrease morbidity and mortality through the institution of early medical and surgical therapy.