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Baby-friendly signs also include some that have no relationship to ASL These include the signs that babies in our research studies spontaneously created Since we know that babies can easily do these signs (because they came from the babies themselves), we include these for your use These The signs that babies create them- include signs for bird, fish, dog, flower, selves often involve large muscle pig, and many more Baby-friendly signs take advanmovements within their faces, heads, and whole bodies rather tage of a baby s natural progresthan their fingers because control sion of motor skills development, thereby making it easier for litof the fine motor movements of tle hands to master the signs they their fingers develops much later need to get their messages across As your newborn grew into a sixmonth-old, she gained greater control over her body.

October, slightly later than is customary for the other arboviruses Venezuelan equine encephalitis is common in South and Central America; in the United States it is practically con ned to Florida and the southwestern states California virus encephalitis predominates in the northern Midwest and northeastern states After West Nile, the La Crosse variety is perhaps the most frequent identi able arbovirus encephalitis in the United States Rabies infections occur worldwide, but in the United States they are seen mostly in the Midwest and along the West Coast Japanese B encephalitis (the most common encephalitis outside of North America), Russian spring-summer encephalitis, Murray Valley encephalitis (Australian X disease), and several less common viral encephalitides are infrequent in the United States or, as in the case of West Nile fever, have appeared only recently.

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With the ease and rapidity of travel, many of these will undoubtedly increase in number in North America and parts of Europe where they have not been seen hitherto Infectious mononucleosis, which is a primary infection with EBV, is complicated by meningitis, encephalitis, facial palsy, or polyneuritis of the Guillain-Barre type in a small proportion of cases Each of these neurologic complications can occur in the absence of the characteristic fever, pharyngitis, and lymphadenopathy of infectious mononucleosis The same is true of M pneumoniae In these two diseases there is still uncertainty as to whether they are true infectious encephalitides or postinfectious complications, as discussed in Chap 32 Recent evidence from PCR testing of spinal uid is consistent with a direct infection in some cases Varicella zoster and CMV are other herpes-type viruses that may cause encephalitis.

First she could lift her head, then her shoulders, then her torso This natural progression of directional development is what is known as cephalocaudal development, literally development from the head to the tail A second directional principle of physical development is known as proximodistal development from the close to the distant and explains why a baby s physical control proceeds from the center of her body outward to her extremities, first to her shoulders, then to her arms, then to her hands, and finally to her fingers Because control of hands and fingers occurs so much later, baby-friendly signs often involve the use of a baby s face (especially the mouth), head, and whole body in the form of gross motor (rather than fine motor) movements.

minute while an individual is idle; it is suppressed during concentration and emotional excitement The fundamental role of swallowing is to move food from the mouth to the esophagus and thereby to begin the process of digestion, but it also serves to empty the oral cavity of saliva and prevent its entry into the respiratory tract Since the oropharynx is a shared conduit for breathing and swallowing, obligatory re exes exist to assure that breathing is held in abeyance during swallowing Because of this relationship and the frequency with which dysphagia and aspiration complicate neurologic disease, the neural mechanisms that underlie swallowing are of considerable importance to the neurologist and are described here The reader is also referred to other parts of this book for a discussion of derangements of swallowing consequent upon diseases of the lower cranial nerves (Chap 47), of muscle (Chap.

They are discussed in relation to the particular clinical settings in which they occur De nite cases of epidemic encephalitis (encephalitis lethargica) have not been observed in acute form since 1930, though an occasional surviving patient with a residual parkinsonian syndrome is still seen in neurology clinics However, various movement disorders including parkinsonism are being seen as a residua of encephalitis from the aviviruses The latency from infection to these complications is brief, or may be present from the outset, quite unlike encephalitis lethargica The relative frequency of the various viral infections of the nervous system can be appreciated from several studies An early series from the Walter Reed Army Institute comprising 1282 patients is particularly noteworthy in that a positive laboratory diagnosis was achieved in more than 60 percent of cases (Buescher et al) a higher rate than in almost any subsequent study of comparable size.

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