Subversion

This chapter explores the second stage of the metagnostic narrative arc: subversion. Following the conception of a metagnostic revelation as both recognition and misrecognition, it examines the ways in which the revelation may unsettle labels and categories. First, central concepts of disability studies are introduced and explored, and it is suggested that terms such as disability and impairment are illuminated and interrogated by a metagnostic revelation, as it breaches the expected mapping between body and classification. Indeed, situating a given revelation requires a sudden renegotiation of the ontological balance between biological impairment and socially constructed disability, and also subverts customary narrative strategies for situating disability. Second, the individual’s relationship with a given disease is seen anew and challenged in light of metagnosis, as are concepts of disease, illness, and sickness. This chapter also serves as an introduction to key concepts in disability studies and philosophy of medicine.

Epilepsy in elderly patients: focus on treatment

Epilepsy is a disorder widely distributed across all age groups, although its incidence and prevalence favours elderly patients. In this population the development of epilepsy is mainlyrelated to other brain disorders that facilitate the occurrence of late seizures, mostly of focal onset. Apart from the difficulties faced in current practice with the appropriate diagnosis of the epileptic nature of the episodes, old subjects require an individualised drug treatment, tailored on their characteristics, such as comorbidity, polytherapy, age-associated biological impairment and compliance. Among the various antiepileptic drugs available for the treatment of epilepsy, rational selection and combination of drugs should drive both initiation and maintenance of the treatment. Choice of antiepileptic drugs should first focus on avoidance of adverse effects and potential drug interactions. The pharmacological control of seizures is usually favourable at this age, with a good prognosis. However, alternative therapeutic options should be considered as soon as drug-response is unsatisfactory.