THE EPILEPSIES: ETIOLOGY AND PREVENTION.

Abstract

Edited by Prakash Kotagal and Hans O. Luders .1998. Pp. 587. San Diego: Academic Press.Price $159.95. ISBN 0-12-422150-5. The one-time Cinderella speciality is now at the ball. The dull world of two seizures (petit mal, grand mal), two drugs (phenytoin, phenobarbitone) and too bad is history. Extraordinary advances in imaging, telemetry, anticonvulsants and the curative hope of surgery have put paid to much shoulder shrugging and placed epilepsy in its deserved spotlight. On to this stage is welcomed another epilepsy text. Prakash Kotagal and Hans Luders have brought together the proceedings of the 7th International Cleveland Clinic–Bethel Symposium (1996) on the aetiology and prevention of epilepsy. They deserve congratulation for co-ordinating an ambitious project, overseeing 150 international contributors to 64 chapters. The scope is broad with the book's strength lying in its clear description of the main structural aetiologies of epilepsy, especially cortical dysplasia, mesial temporal sclerosis, tumours, trauma, vascular disease and infection. There is a fairly rounded feel to most subjects presented though it sometimes lacks the seamless transition between chapters that is so difficult to achieve in a multi-author hybrid. Multi-authorship gives breadth and a refreshingly varied approach but also frequent overlap in some areas and holes in others. The Epilepsies: Etiology and Prevention might suggest a book whose first third would be molecular, biochemical and genetic, the areas where our understanding of the epilepsies and their treatments mostly continues to grow. Luders and Kotagal actually pay remarkably scant attention to these aspects of epilepsy. Their emphasis on structural aetiology gives us a book that is more aimed at the practical clinician than are its rival texts. The low profile of molecular biology will be refreshing to those many physicians who develop absence status at the first mention of slow and fast ion channels, of AMPA or of …