The JAMA Neurology feature "Images in Neurology" features the case of a 25-year-old right-handed physical education student who was buried by an avalanche during a ski tour and endured 15 minutes of hypoxia (oxygen deficiency). He developed involuntary myoclonic jerking (brief, involuntary twitching of muscles) of the mouth induced by talking and of the legs by walking. Weeks later when he was trying to solve Sudoku puzzles he developed clonic seizures (rapid contractions of muscles) of the left arm. The seizures stopped when the Sudoku puzzle was discontinued. Berend Feddersen, M.D., Ph.D., of the University of Munich, Germany, and coauthors suggest oxygen deficiency most likely caused some damage to the brain. The patient stopped solving Sudoku puzzles and has been seizure free for more than five years.
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