SEARCH

SEARCH BY CITATION

Book Review: Childhood Epilepsy: Management from Diagnosis to Remission Edited by Richard Appleton and Peter Camfield Cambridge : Cambridge University Press , 2011 £35.00 (Paperback), pp 166 ISBN : 978-0-521-76325-7

There are over 800 books on epilepsy that have been published during the past 4 years, so each new book on this topic faces a challenge to justify its existence. Childhood Epilepsy: Management from Diagnosis to Remission meets this challenge admirably. It is a concise book that offers guidance not only on initial diagnosis and treatment but also, importantly, on the longer-term management of childhood epilepsy and its comorbidities through to remission or transfer to adult services.

Three core chapters cover epilepsy beginning in infancy, middle childhood, and adolescence. The main epilepsies and epilepsy syndromes in each age group are well described. Advice on management not only addresses seizure treatment but also the psychosocial and cognitive implications of epilepsy as well as family adjustment. Of particular value is the guidance on first, second, and subsequent lines of treatment for intractable epilepsies, with advice on when to refer to more specialist colleagues. The section on transfer to adult services in the adolescence chapter is especially useful, and considers two broad categories of adolescents: those with relatively normal intelligence and those with significant learning difficulties.

There are additional, helpful chapters on more general aspects of epilepsy that cover diagnosis, risks and hazards, and status epilepticus (both convulsive and non-convulsive). A chapter on prevention begins by considering how some epilepsies might be avoided altogether and then moves on to discuss avoidance of an incorrect diagnosis of epilepsy or inappropriate choice of medication. These cautionary themes are developed further in the final medico-legal chapter. For its size, this book offers a great deal of information on the management of childhood epilepsy. Of course, it does not pretend to provide a comprehensive account of epilepsy and so discussion of pathophysiology, genetics, classification, and controversies in management needs to be sought elsewhere, although these issues are all touched on in the book.

An author from North America has been paired with one from the UK for each chapter and whilst the principles of epilepsy management are universal, local differences are covered (such as preferred first- and second-line medication, or information about national guidelines and support groups). Practical tips from the experienced authors shine through in comments such as the oldest female relative usually gives the best family history, children may describe the onset of seizures in benign childhood epilepsy with centrotemporal spikes (BECTS) as a fizzing of the tongue, and a warning that the benefit of identifying epilepsy syndromes does not justify bending the criteria to squeeze in a diagnosis.

This book is intended for general paediatricians responsible for the care of children with epilepsy – but it is also relevant to neurodisability paediatricians and ought to serve as a useful introduction to epilepsy management for paediatric neurologists in training. The emphasis on practical guidance through to remission or transfer to adult services makes this a welcome book that should be greatly appreciated by its target audience.