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In This Issue of JAMA Neurology |

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JAMA Neurol. 2016;73(4):369. doi:10.1001/jamaneurol.2015.2449.
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Sillanpää and coauthors determine whether progress has been made in the prevention of epilepsy in Finland during the last 40 years. Using a long-term national register study of 5.04 million Finnish individuals, they looked at first-time inpatient admissions in Finland for a diagnosis of epilepsy from 1973 to 2013. They report no evidence that progress has been made in preventing new-onset epilepsy in those younger than 65 years in the last 40 years; in fact, there was a nearly 5-fold rise of new-onset epilepsy among the elderly population. Editorial perspective is provided by Mark Agostini, MD.

Armangué and colleagues report the clinical and immunological features of idiopathic opsoclonus-myoclonus syndrome (I-OMS) and paraneoplastic OMS (P-OMS), the occurrence of antibodies to cell surface antigens, and the discovery of a novel cell surface epitope. Retrospective cohort study and laboratory investigations of 114 adult patients with OMS at a center for autoimmune neurological disorders were done between January 2013 and September 2015. Patients with I-OMS responded better to treatment and had fewer relapses than those with P-OMS. Editorial perspective is provided by Jérôme Honnorat, MD, PhD.

Aguirre-Acevedo et al evaluate the onset and rate of cognitive decline during preclinical autosomal dominant Alzheimer disease (ADAD) and the effect of socioeconomic, vascular, and genetic factors on the cognitive decline. They performed a retrospective cohort study from January 1, 1995, through June 31, 2012, of individuals from Antioquia, Colombia, who tested positive for the ADAD-associated PSEN1 E280A mutation. Preclinical cognitive decline was evident in PSEN1 E280A mutation carriers 12 years before the onset of clinical impairment. Editorial perspective is provided by Diane B. Howieson, PhD, ABPP-CN.


Jones and Cascino review the evidence for the use of neuroimaging studies in the selection of patients with drug-resistant temporal lobe epilepsy for focal cortical resection and discuss the prognostic importance of selected techniques. Randomized clinical trials, meta-analyses, and clinical retrospective case studies (≥20 patients with ≥1 year of follow-up) were identified. There is strong evidence that preoperative magnetic resonance imaging (MRI)–identified hippocampal atrophy consistent with mesial temporal sclerosis concordant with the seizure origin in the temporal lobe is a significant factor associated with a favorable outcome. Positron emission tomography studies may be valuable in individuals with unremarkable MRI findings.




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