Int Rev Neurobiol
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The knowledge base for treating elderly persons with epilepsy is limited. There are few known knowns, many known unknowns, and probably many unknown knowns, that is, the things we know that "ain't so." We know that the incidence and prevalence of epilepsy is higher in the elderly than any other age group, that the elderly are not a homogeneous group, that epilepsy is much more common in the nursing home population than in the community-dwelling elderly, and that antiepileptic drug (AED) use varies greatly among countries, but that in all, the older AEDs (phenytoin, phenobarbital, and carbamazepine) are the most commonly used. ⋯ Some unknown knowns (i.e., misconceptions) are that the elderly need levels of AEDs similar to those for younger adults and that AED levels do not fluctuate widely. This book is designed to help the reader understand the issues and, hopefully, to stimulate research to provide answers for the known unknowns.
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Understanding the importance of cortical lesions in MS pathogenesis has changed. Histopathologic studies using new immunohistochemical methods show that cortical lesions can be detected more frequently than previously reported. Newer MRI sequences also detect cortical lesions more accurately. ⋯ We observed a significant correlation between T2-LV and GM atrophy in all slice thickness (r = -0.4 to -0.48, p = 0.001-0.003) and a modest relationship between cortical and cortical-juxtacortical LVs and disability, especially at 1.5-mm slice thickness (r = 0.35, p = 0.025). Use of thinner slices (1.5 mm) on 2D-FLAIR images can significantly increase the sensitivity and precision of detecting cortical and juxtracotical lesions in patients with MS. Cortical and juxtacortical lesions contribute more to disability development than total T2-LV alone.