Book review

Abstract

Recent advances in neuroimaging techniques have resulted in drastic changes in the diagnosis and management of epilepsies. Malformations of cortical development, which are often responsible for intractable epilepsies but could be diagnosed only with neuropathological examinations, can now be diagnosed non-invasively in living patients. A significant number of patients with localization-related epilepsies, which would have been classified as cryptogenic, are now diagnosed as having symptomatic epilepsy with clearly identified cortical lesions. This has given a great impact on the management of intractable localization-related epilepsies, since an increasing number of patients with intractable epilepsies due to localized cortical dysplasias or migration disorders have been treated successfully with epilepsy surgery. Meanwhile, there have been significant advances in the understanding of the basic mechanisms involved in the normal and abnormal cortical development. These have a direct relevance to the neurobiology of epilepsies. In these respects, this book provides both clinicians and basic neuroscientists with a timely summary of recent advances in the basic and clinical aspects of symptomatic localization-related epilepsies due to abnormal cortical development. It is based on a multidisciplinary meeting held in Venice in October 1997, and consists of six parts. Following a succinct synopsis by Avanzini, Frederick Andermann reviewed the history, current problems and future perspective of our understanding of epileptogenic cortical dysplasia in Part I. Part II consists of six chapters and deals with basic neuroscience of normal and abnormal cortical development. Part III has four chapters and deals mainly with morphological and electrophysiological features and epileptogenesis of cerebral dysplasia in animal models. Part IV, consisting of nine chapters, covers electroclinical, imaging and neuropathological studies of malformations of cortical development. Part V has two chapters and deals with the role of homeobox genes and molecular mechanisms of neuronal migration disorders. The final part, part VI, describes in two chapters, surgical approaches and future perspective in the treatment of epilepsies due to cortical dysplasias and neuronal migration disorders. As some of the authors suggest, there is a definite need for a clear definition of entities such as dysplasia, hamartoma, heterotopia, microdysgenesis, dysplastic tumor and migration disorders. Although this book is not a comprehensive textbook, it brings together excellent, up-to-date contributions of every specialist from basic to clinical neuroscience in one volume. Each chapter describes succinctly what is known and what should be done in the future. I believe that this book will help clinicians and basic scientists to understand the current status of an important aspect of epileptology and developmental neurobiology efficiently.