Victor Dostrow

The new generation of AEDs is not perfect. Is anyone surprised by this?

Chocolate is good. And, in small quantities, it has properties which may promote health and treat disease. One hypothesis is that the antioxidants, largely flavonoids, are responsible for these positive effects.

Recently, there has been some interesting data about stroke that is worth mentioning.

Traumatic brain injury (TBI) raises the risk of subsequent epilepsy (post-traumatic epilepsy: PTE). The risk also correlates with TBI severity, and is higher in the presence of a preexisting seizure disorder. These are fairly well accepted principles. However, much about the relationship between TBI and epilepsy remains unclear.

Dementia is a terminal illness. However, people with advanced dementias often languish in skilled nursing facilities, far from the ministrations of specialists. And, with reasonable luck, they have directives that specify that they are not to be taken to the hospital in the event of a respiratory arrest. Consequently, most of us are not privy to the mechanisms of demise in such situations.

The Internet is filled with reports of remarkable cognitive enhancement with various nostrums. Many are not regulated, and the pages are typically associated with glowing testimonials and a link to sign up for uninterrupted (and uninterruptible) delivery of the miracle substance.

There are two manuscripts of note regarding cognitive function and cognitive decline in this week's issue of the journal Neurology. While I have commented previously about various aspects of dementia, cognitive decline and mild cognitive impairment (MCI) are more common and the latter may be a precursor to dementia.

From a pharmacologic perspective metoclopramide is much closer to antipsychotic drugs, in that it is, in part, a blocker of central dopamine receptors.

In well selected patients with refractory epilepsy, seizure surgery is a safe and effective treatment option. Sadly, it is also much underused.