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Advances in neurology. Vol. 46. Intensive neurodiagnostic monitoring
B O O K REVIEWS
Advances in neurology. Vot. 46. Intensive neurodiagnostie monitoring. - - R.J. Gumnit (Ed.) (Raven Press, New York, 19~7, 331 p., U.S. K56.00) This book ~s the second one pubhshed this year on the same topic (Suppl 37 to E E G J ) and is the result of an International Conference on Intensive NeurodJagnostlc i o m tormg, held m San Francisco, CA in 1984 There are 18 chapters placed somewhat artificially into 5 sections from 23 contributors, most (19) of whom came from the U S.A. The longest section is the first on combined vadeo and EEG recording_ It ts appropriate that Ives was the author of the first chapter since he was so instrumental in developing these techmques, which are convemently outlined m this chapter Dreffuss then presents (again) the classification of semures and also of epileptic syndromes, clarifying the lmphcatlons for therapy It is a bit curious why this chapter, although clearly presented from an outstanding authonty, was included in a book on intensive m o m t o n n g . The next account is by the U C.L_A_ group and is more than twace as long as any other chapter, beginning with a new classification of the epilepsies, dlsUngulshmg u n k n o w n from ldentifmble etlologms The bulk of this account consists of 10 illustrated cases and the lessons learned from intensive m o m t o r m g The next chapter by Wllh a m s o n is helpful m differentiating frontal, temporal and occipital lobe complex partial seizures M o m t o n n g by mtracramal electrodes is next given by Engel and Crandall offenng a balanced dascusslon of the proper usefulness of these techmques A n excellent updated s u m m a r y of neonatal seizures ts then presented by Tharp, who includes m l'us discussion some important, but poorly understood, E E G patterns It was somewhat surpnsmg, however, that Tharp presented only preh m m a r y data on qmeseent periods m only 12 neonates without chscusslon of the exasting hterature on this same topic. The practical considerations, in a d d m o n to the general dascusslon of seizures, will be important to most readers Kellaway's chapter on m o m t o n n g infants mcludes some important cantions about the relationship between E E G and chmcal data, including comments on 'treating the EEG? The second section on ambulatory E E G begins wath Ebersole's helpful s u m m a r y of all facets of this techmque and Stores follows wath his extensive experience with the special problems in children_ Bllmae extends the discussion to adults and addresses wisely and properly the important plus versus minus aspect of this techmque, including the costs Excellent data are included in this chapter as to the effectiveness of the apparatus_ The next chapter (Bhimhardt) is on special problems and addresses one of the most important problems in neurology, the syncopal attacks and good data are presented to argue that m a n y 'blackouts' are from the head, not the heart R a m a m has enlarged his well-known pubhshed work on aggression and dyscontrol syndromes into a helpful s u m m a r y of the problem_ The evaluation of the efficacy of antiepdeptlc drugs (Lepplk) and presurgmal evaluataon (Gates) is also handled well in all aspects Data reduction is presented by two experts, G o t m a n and
97 Frost The former, always the epitome of clanty, shows how a computer-assisted m o m t o r can allow for easy revaew, although his suggestion that we rmght see 64 channels in the future could be considered somewhat unhkely Frost is convincing that rmcroprocessor-based systems wall soon be a routine component m m o m t o r m g laboratones. The summaries by Mattson and G u m m t wd.l be helpful to the reader m placing into perspective these techmques representing a great advance m neuro&agnostic capabthty. This revaewer highly recommends this book to electroencephalographers and epileptologtsts, who m 1987 must be farmhar with intensive m o m t o r m g techmques to evaluate thear own patients_ John R. Hughes
Umvers~ty of lIhnols Medical Center, Chicago, IL 60612 (U S A )
Epilepsy in children. - - J. Aicardi (Raven Press, New York, 1986, 413 p., U.S. $67.50) This book is authored by an internationally renowned epdeptologlst whose writing is perfectly clear and whose expenence is extensive. Not only did this rewewer read the book carefully, but he also outlined the majority of it for future teaching efforts_ After a short section on general aspects, the author has d m d e d his work into 3 major sections (1) major types of seizures and syndromes, (2) epileptic mamfestaUons m relation to age, cause, duraUon and precipitation, and (3) diagnosis, prognosis and treatment The treatment of lnfanUle spasms is excellent Alear& clarifies that the lctal E E G has patterns other than the decremental chseharge, thus arguing against the motion that the attacks may be non-epileptogemc and only release phenomena. Discussion of treatment is complete, favonng hormonal therapy only in cryptogemc or doubtful cases The Lennox-Gastaut syndrome (LGS) is thoroughly described, perhaps wathout suffmlent reference to Cnbbs, and introducing smnlar forms w~th other appelaUons These are made somewhat clear by a diagram showing the comphcated overlap between genetic factors and brain damage, between fast and slow spike and wave and fmally between myoclomc epilepsy and the LGS. Aacardl tnes to make clear other confusing or overlapping condmons, hke severe myoclomc epilepsy, centrencephahc myoclomc, true myoclomc and cryptogemc myoclonic epilepsy All aspects of these conditions are handled well In the chapter on myoclomc epilepsies of late childhood and adolescence, this excellent book is marred by the repetition of 15 hnes (p 67-68), likely as a gross error of the copy editor. As m the prewous chapter Aacarch tries to clarify the use of a number of different terms for stmalar forms of seizures with considerable success However, his recommendation that sleep depnvatlon for 24 h (9 'always be performed when there is a suspicion of bemgn myoclomc juvende epilepsy' seems somewhat excessive In deahng wath typical absence seizures, the author presents a very clear p~cture of the mare forms with all of its variants, like eyehd myocloma, focal components, etc The reviewer was somewhat surprised, however, at the absent reference to Browne
Advances in neurology. Vot. 46. Intensive neurodiagnostie monitoring. - - R.J. Gumnit (Ed.) (Raven Press, New York, 19~7, 331 p., U.S. K56.00) This book ~s the second one pubhshed this year on the same topic (Suppl 37 to E E G J ) and is the result of an International Conference on Intensive NeurodJagnostlc i o m tormg, held m San Francisco, CA in 1984 There are 18 chapters placed somewhat artificially into 5 sections from 23 contributors, most (19) of whom came from the U S.A. The longest section is the first on combined vadeo and EEG recording_ It ts appropriate that Ives was the author of the first chapter since he was so instrumental in developing these techmques, which are convemently outlined m this chapter Dreffuss then presents (again) the classification of semures and also of epileptic syndromes, clarifying the lmphcatlons for therapy It is a bit curious why this chapter, although clearly presented from an outstanding authonty, was included in a book on intensive m o m t o n n g . The next account is by the U C.L_A_ group and is more than twace as long as any other chapter, beginning with a new classification of the epilepsies, dlsUngulshmg u n k n o w n from ldentifmble etlologms The bulk of this account consists of 10 illustrated cases and the lessons learned from intensive m o m t o r m g The next chapter by Wllh a m s o n is helpful m differentiating frontal, temporal and occipital lobe complex partial seizures M o m t o n n g by mtracramal electrodes is next given by Engel and Crandall offenng a balanced dascusslon of the proper usefulness of these techmques A n excellent updated s u m m a r y of neonatal seizures ts then presented by Tharp, who includes m l'us discussion some important, but poorly understood, E E G patterns It was somewhat surpnsmg, however, that Tharp presented only preh m m a r y data on qmeseent periods m only 12 neonates without chscusslon of the exasting hterature on this same topic. The practical considerations, in a d d m o n to the general dascusslon of seizures, will be important to most readers Kellaway's chapter on m o m t o n n g infants mcludes some important cantions about the relationship between E E G and chmcal data, including comments on 'treating the EEG? The second section on ambulatory E E G begins wath Ebersole's helpful s u m m a r y of all facets of this techmque and Stores follows wath his extensive experience with the special problems in children_ Bllmae extends the discussion to adults and addresses wisely and properly the important plus versus minus aspect of this techmque, including the costs Excellent data are included in this chapter as to the effectiveness of the apparatus_ The next chapter (Bhimhardt) is on special problems and addresses one of the most important problems in neurology, the syncopal attacks and good data are presented to argue that m a n y 'blackouts' are from the head, not the heart R a m a m has enlarged his well-known pubhshed work on aggression and dyscontrol syndromes into a helpful s u m m a r y of the problem_ The evaluation of the efficacy of antiepdeptlc drugs (Lepplk) and presurgmal evaluataon (Gates) is also handled well in all aspects Data reduction is presented by two experts, G o t m a n and
97 Frost The former, always the epitome of clanty, shows how a computer-assisted m o m t o r can allow for easy revaew, although his suggestion that we rmght see 64 channels in the future could be considered somewhat unhkely Frost is convincing that rmcroprocessor-based systems wall soon be a routine component m m o m t o r m g laboratones. The summaries by Mattson and G u m m t wd.l be helpful to the reader m placing into perspective these techmques representing a great advance m neuro&agnostic capabthty. This revaewer highly recommends this book to electroencephalographers and epileptologtsts, who m 1987 must be farmhar with intensive m o m t o r m g techmques to evaluate thear own patients_ John R. Hughes
Umvers~ty of lIhnols Medical Center, Chicago, IL 60612 (U S A )
Epilepsy in children. - - J. Aicardi (Raven Press, New York, 1986, 413 p., U.S. $67.50) This book is authored by an internationally renowned epdeptologlst whose writing is perfectly clear and whose expenence is extensive. Not only did this rewewer read the book carefully, but he also outlined the majority of it for future teaching efforts_ After a short section on general aspects, the author has d m d e d his work into 3 major sections (1) major types of seizures and syndromes, (2) epileptic mamfestaUons m relation to age, cause, duraUon and precipitation, and (3) diagnosis, prognosis and treatment The treatment of lnfanUle spasms is excellent Alear& clarifies that the lctal E E G has patterns other than the decremental chseharge, thus arguing against the motion that the attacks may be non-epileptogemc and only release phenomena. Discussion of treatment is complete, favonng hormonal therapy only in cryptogemc or doubtful cases The Lennox-Gastaut syndrome (LGS) is thoroughly described, perhaps wathout suffmlent reference to Cnbbs, and introducing smnlar forms w~th other appelaUons These are made somewhat clear by a diagram showing the comphcated overlap between genetic factors and brain damage, between fast and slow spike and wave and fmally between myoclomc epilepsy and the LGS. Aacardl tnes to make clear other confusing or overlapping condmons, hke severe myoclomc epilepsy, centrencephahc myoclomc, true myoclomc and cryptogemc myoclonic epilepsy All aspects of these conditions are handled well In the chapter on myoclomc epilepsies of late childhood and adolescence, this excellent book is marred by the repetition of 15 hnes (p 67-68), likely as a gross error of the copy editor. As m the prewous chapter Aacarch tries to clarify the use of a number of different terms for stmalar forms of seizures with considerable success However, his recommendation that sleep depnvatlon for 24 h (9 'always be performed when there is a suspicion of bemgn myoclomc juvende epilepsy' seems somewhat excessive In deahng wath typical absence seizures, the author presents a very clear p~cture of the mare forms with all of its variants, like eyehd myocloma, focal components, etc The reviewer was somewhat surprised, however, at the absent reference to Browne