Book Review

Abstract

In countries with a long history of traditional medical practice (e.g., China and India), it is customary to find patients adopting traditional therapies and “Western” medicines side by side. However, complementary and alternative medicine (CAM) is becoming increasingly popular, even in many Western countries where “conventional” treatments are readily available. Demographic studies conducted in the United States estimated that the use of CAM increased by almost 50% between 1990 and 1997, with the number of total visits to CAM providers exceeding that to all U.S. primary care physicians. Patients with epilepsy are no exception. Surveys conducted in the United States and United Kingdom suggest that up to one-third of patients with epilepsy take herbs or dietary supplements or both, and that the majority of these patients do not discuss such use with their physicians. However, as the editors of this book pointed out, the vast majority of physicians do not understand and are uncomfortable with CAM. This book is, therefore, a very timely resource publication on the topic of CAM and epilepsy. The chapters, written by CAM practitioners who presented their work during a special conference at the NYU Epilepsy Center on CAM and epilepsy, cover a very diverse range of therapies from neurobehavior, biofeedback, and meditation, to massage, aromatherapy, and from herbal medicines, nutritional approaches, oxygen therapy, to chiropractic manipulation and music and art therapies. One chapter deals with research methods for CAM. The chapters are generally well referenced, and each chapter is followed by a brief commentary by the editors to provide a perspective on the content, albeit often from the standpoint of Western medical culture. Overall, the book has served the purpose of introducing the readers coming from a Western medical background to the various CAM therapies currently used to treat epilepsy. In-depth discussion is not feasible because of the large number of treatment modalities covered (more than 20). In addition, because the chapters are written by different authors, their formats and standards are variable. I particularly like the chapter, Herbal Therapy in Epilepsy, which critically and authoritatively appraises the evidence of the efficacy and safety of a range of herbal medications and their potential interactions with antiepileptic drugs. Other chapters with more anecdotal reporting of personal experiences are well supplemented by comments from the editors to give a more balanced view on the subjects. Because most of the authors are unknown to conventional physicians unfamiliar with the field of CAM, it would be helpful if their background and affiliation could be provided to the readers. Very few books of a similar nature are available on a topic of increasing relevance to everyday clinical practice. I strongly recommend this book to all professionals caring for patients with epilepsy.