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Mandatory generic substitution of antiepileptic drugs is an increasingly common practice that has many physicians and patients concerned because of the potential for breakthrough seizures and adverse effects. Do the same concerns apply to the treatment of newly diagnosed epilepsy? Peter Wolf investigates.
Although there have been substantial innovations in antiepileptic drug therapy over the past 15 years, the proportion of patients with medically refractory epilepsy has remained largely unchanged, highlighting the need for new therapeutic strategies. In this article, Stacey and Litt review recent progress in the development of implantable devices designed to detect, predict and extinguish seizures, and consider the challenges that lie ahead, including improvements in seizure prediction and personalized control.
Neuromyelitis optica (NMO) is a rare neuroinflammatory disorder that predominantly affects the optic nerves and spinal cord. NMO was originally considered to be a subtype of multiple sclerosis, but the recent discovery of NMO-specific serum autoantibodies has caused it to be reclassified as a distinct disease. In this article, Jariuset al. review clinical, serological and pathological findings in NMO, and discuss the evidence supporting an antibody-mediated mechanism in its pathogenesis.
Over the past century, the pathophysiology of ischemia in the borderzones between the large cerebral arteries has been the topic of considerable debate. Two seemingly mutually exclusive mechanisms—hemodynamic failure and microembolism—have been proposed to explain this phenomenon. As Förster et al. discuss in this article, a new model of borderzone infarction, incorporating both hypoperfusion and microembolism, is now emerging.
In this Case Study, a 66-year-old man presented with a clinical syndrome consistent with frontal variant frontotemporal dementia, but neuropathological evidence established a diagnosis of frontal variant Alzheimer's disease. The authors provide detailed, longitudinal clinical data describing the course of this rare but increasingly recognized variant of Alzheimer's disease.
