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The major-ity of these patients will also have subclinical seizures after discontinuation of therapy(11,29). It must be based on a careful assessment of fracture stability

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Ungual paresis could reflect a brain-stem abnormality as well but fasciculation or atrophy ofthe tongue might represent denervation, which is seen inALS. It is also essential to inspect the surgicalfield and remove any dead bone or compromised soft tissue.

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