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The neutrobehavioral treatment of epilepsy
BOOKREVIEWS the structures noted. The price is similar to other radiological texts of similar length and quality. Gregory L. Holmes, M.D. Department of Neurology Harvard Medical School Children's Hospital Boston, MA, U.S.A.
Skull and Spine Imaging. An Atlas of Differential Diagnosis, by Ronald L. Eisenberg. New York: Raven Press, 1994, 302 pp. Price: $95.00. With the advent of widespread MRI, there has been a plethora of books on neuroimaging, many of which cannot be differentiated from one another. Dr. Eisenberg approaches neuroradiology in a different fashion, emphasizing differential diagnosis. Neuroradiological findings are listed, and differentiating features of various lesions responsible for the finding are listed and discussed. For example, under the category intraventricular masses, the author describes the imaging finding of a choroid plexus papilloma, colloid cyst, meningioma, ependymoma, giant cell astrocytoma, dermoid/epidermoid, primitive neuroectodermal tumor, teratoma, lymphoma, and oligodendroglioma. Excellent images of each of the entities are provided and differentiating points described. Although this information is provided in other sources, it is a very useful teaching tool to list all the entities in tabular form. • The book is divided into two parts: skull patterns (45 chapters) and spine patterns (26 chapters). The book is full of clearly presented, excellent examples. In general the reproduction of the scans is superb. The negatives are few. The epileptologist looking for a differential diagnosis of mesial temporal lesions will not find it in this book. The reader wishing to find additional reading material on topics discussed will be disappointed. There are no references included anywhere in the book. Despite these problems, the book will be a useful addition to the clinician's library. Once purchased, it is likely to be used extensively. Gregory L. Holmes, M.D. Department of Neurology Harvard Medical School Children's Hospital Boston, MA, U.S.A.
The Neurobehavioral Treatment of Epilepsy, edited by David I. Mostofsky and Yngve Loyning. Hillsdale, NJ: Erlbaum, 1993, 350 pp. Price: $69.95.
Perhaps the American community of neurologists will be most surprised to learn how increasingly common it has become for nonphysicians to have taken to the study and indeed treatment of the seizure disorders, and how successful the nondrug and nonsurgical interventions have proven themselves to be. Among European (and many Asian) neurology centers, the importance of psychological and organic variables in the understanding of epilepsy and its control has long been accepted and has benefitted from the participation of specialists whose training crosses traditional disciplinary boundaries. The history of epileptic phenomena has repeatedly confirmed the importance of the interpersonal and intrapersonal factors in the modulation of the course of the disorder. Admittedly, it is only relatively recently that with the translation to scientifically orchestrated experiments and clinical demonstrations in which these factors were manipulated to affect the severity of the disorder that it has been possible to confidently establish the utility of "alternative" behavioral treatments either as part of an ongoing comprehensive therapeutic program or, on occasion, as the sole strategy for clinical management. This has been particularly true for those cases that have proven to be intractable to anticonvulsant drug programs and for whom surgery was not a viable option. Certainly the more dramatic examples of success may be seen in the context of EEG biofeedback protocols which, as Fried (this volume) forcefully points out, may itself be a consequence of the effects of respiratory activity. Even with the less dramatic and routine application of other behavioral techniques directed to patients who have suffered the debilitating aftereffects of countless convulsive attacks, the patients report a measure of improvement that is nothing less than impressive and clinically significant. However wellknown these positions may be, the book we review is singularly important, being the first of its kind dedicated as it is to behavioral treatment opportunities for seizure control. The book provides us with a coherent collection of perspectives on behavioral epilepsy, although much of the writings will already be familiar to those who have followed the developments in this area. The chapters, all authored by many well-known and well-published authorities from the international community of neurology and neurosciences, present timely and articulated summaries of relevant "neurobehavioral" directions for epilepsy treatment. Included among the topics are discussions of EEG biofeedback,
j EPILEPSY,VOL. 7, NO. 3, 1994 249
BOOK REVIEWS breathing, behavioral modification, magnetostimulation, and exercise. Nutrition, steroids, catamenial epilepsy, and pseudoseizures are also examined for their "neurobehavioral" properties. Psychosocial factors and methodological issues are also discussed in separate chapters, thereby increasing the value of this work to both the clinician and the researcher. This book is certainly the first of its kind for epilepsy, but most importantly it brings the potential power of psychological and behavioral considerations to the inescapable attention of even the most hard-nosed theoretical or applied neuroscientist. It is a book that is a must for every physician and every neurologist. Without question it should be part of the library for the medical student for whom a holistic appreciation of disorders and of patient management is often fragmentary at best. The realization that neural neurochemical, and other organic functions and dysfunctions can be altered without drugs or invasive procedures is found to upset the uncritical and complacent among us. All the better. This work is highly recommended as well for psychiatry, psychology, nursing, rehabilitation, and allied health personnel and agency officers who work with epileptics and their families. The distinguished editors as well as the publisher deserve our praise and thanks for a wellproduced and useful--if perhaps at times controversial and provocative--monograph.
pages) do not distinguish themselves particularly for the presentation of truly new information. (It would have been nice to learn how magnetoencephalography has affected the surgical developments, if at all.) Indeed, many (if not most) of the authors are familiar and they have written on this or similar themes in the past. In addition, for a work that carries a copyright date of 1994, it already borders on being dated. Except for a handful of citations (and a small handful at that) the references are several years old. For the specialist who has followed this area, therefore, the value of the writings may be questioned, yet it will certainly be appreciated as a useful introduction to a range of issues and as a means of gaining entry to the relevant literature. It is a nicely produced and illustrated work, incorporating quite a bit of emphasis on neuropsychology, surely a legitimate spin of an editor's prerogative. It might have been helpfulif the editors explained why they provided sample questionnaires and intake survey instruments (and how to make use of the information once received) that are provided as appendices. Even the neuropsychological and psychiatric aspects have not grappled with deficits other than language or emotion, nor was there any serious discussion of surgery with adult and perhaps geriatric patients. All in all, the editors are to be commended for enriching the epilepsy literature with this entry on epilepsy for the 1990s.
Ralph L. Carasso, M.D. Department of Neurology Hillel-Jaffe Hospital Hadera, Israel
David I. Mostofsky, Ph.D. Boston University Boston, MA, U.S.A.
The Surgical Management of Epilepsy, edited by Allen tL Wyler and Bruce P. Hermann. Stoneham, MA: Butterworth-Heinemann, 1994, 277 pp. Price: $75.00. If it suggests a restrictive treatment of surgical aspects of epilepsy, the title will have done something of a disservice to an otherwise useful edited volume that is far more comprehensive. At least 4 of the 22 "chapters" are concerned with psychiatric and general issues of the epilepsies. Certainly, this is not meant as a complaint, for it is encouraging that the editors of a monograph on surgical issues have recognized the need for addressing more than mere technological problems and solutions. Without question, this is a book that should be found in the library of every clinician concerned with epilepsy, especially every clinician in training. The various chapters (with an average length of six
250 J EPILEPSY, VOL. 7, NO. 3, 1994
Neurological Manifestations of Systemic Diseases in Children (The International Review of Child Neurology), Avraham Steinberg and Yitzchak Frank. New York: Raven Press, 1992, 399 pp. Price: $95.00. This book brings a long-awaited, comprehensive review of pertinent topics regarding systemic disease to pediatrics and neurology. Each chapter is organized according to the organ system primarily involved, allowing a rational access to information in pathophysiology, epidemiology,.and clinical manifestations of both neurological syndromes and underlying disorders. The data base is extensive, relatively recent, and largely draws from well-documented studies, providing consultants with reliable and accessible information. The pediatric viewpoint emphasizes the effects of disease on the developing brain in both the prenatal and postnatal periods. Malnutrition and neurological development, congenital malfoimations, and HIV
Skull and Spine Imaging. An Atlas of Differential Diagnosis, by Ronald L. Eisenberg. New York: Raven Press, 1994, 302 pp. Price: $95.00. With the advent of widespread MRI, there has been a plethora of books on neuroimaging, many of which cannot be differentiated from one another. Dr. Eisenberg approaches neuroradiology in a different fashion, emphasizing differential diagnosis. Neuroradiological findings are listed, and differentiating features of various lesions responsible for the finding are listed and discussed. For example, under the category intraventricular masses, the author describes the imaging finding of a choroid plexus papilloma, colloid cyst, meningioma, ependymoma, giant cell astrocytoma, dermoid/epidermoid, primitive neuroectodermal tumor, teratoma, lymphoma, and oligodendroglioma. Excellent images of each of the entities are provided and differentiating points described. Although this information is provided in other sources, it is a very useful teaching tool to list all the entities in tabular form. • The book is divided into two parts: skull patterns (45 chapters) and spine patterns (26 chapters). The book is full of clearly presented, excellent examples. In general the reproduction of the scans is superb. The negatives are few. The epileptologist looking for a differential diagnosis of mesial temporal lesions will not find it in this book. The reader wishing to find additional reading material on topics discussed will be disappointed. There are no references included anywhere in the book. Despite these problems, the book will be a useful addition to the clinician's library. Once purchased, it is likely to be used extensively. Gregory L. Holmes, M.D. Department of Neurology Harvard Medical School Children's Hospital Boston, MA, U.S.A.
The Neurobehavioral Treatment of Epilepsy, edited by David I. Mostofsky and Yngve Loyning. Hillsdale, NJ: Erlbaum, 1993, 350 pp. Price: $69.95.
Perhaps the American community of neurologists will be most surprised to learn how increasingly common it has become for nonphysicians to have taken to the study and indeed treatment of the seizure disorders, and how successful the nondrug and nonsurgical interventions have proven themselves to be. Among European (and many Asian) neurology centers, the importance of psychological and organic variables in the understanding of epilepsy and its control has long been accepted and has benefitted from the participation of specialists whose training crosses traditional disciplinary boundaries. The history of epileptic phenomena has repeatedly confirmed the importance of the interpersonal and intrapersonal factors in the modulation of the course of the disorder. Admittedly, it is only relatively recently that with the translation to scientifically orchestrated experiments and clinical demonstrations in which these factors were manipulated to affect the severity of the disorder that it has been possible to confidently establish the utility of "alternative" behavioral treatments either as part of an ongoing comprehensive therapeutic program or, on occasion, as the sole strategy for clinical management. This has been particularly true for those cases that have proven to be intractable to anticonvulsant drug programs and for whom surgery was not a viable option. Certainly the more dramatic examples of success may be seen in the context of EEG biofeedback protocols which, as Fried (this volume) forcefully points out, may itself be a consequence of the effects of respiratory activity. Even with the less dramatic and routine application of other behavioral techniques directed to patients who have suffered the debilitating aftereffects of countless convulsive attacks, the patients report a measure of improvement that is nothing less than impressive and clinically significant. However wellknown these positions may be, the book we review is singularly important, being the first of its kind dedicated as it is to behavioral treatment opportunities for seizure control. The book provides us with a coherent collection of perspectives on behavioral epilepsy, although much of the writings will already be familiar to those who have followed the developments in this area. The chapters, all authored by many well-known and well-published authorities from the international community of neurology and neurosciences, present timely and articulated summaries of relevant "neurobehavioral" directions for epilepsy treatment. Included among the topics are discussions of EEG biofeedback,
j EPILEPSY,VOL. 7, NO. 3, 1994 249
BOOK REVIEWS breathing, behavioral modification, magnetostimulation, and exercise. Nutrition, steroids, catamenial epilepsy, and pseudoseizures are also examined for their "neurobehavioral" properties. Psychosocial factors and methodological issues are also discussed in separate chapters, thereby increasing the value of this work to both the clinician and the researcher. This book is certainly the first of its kind for epilepsy, but most importantly it brings the potential power of psychological and behavioral considerations to the inescapable attention of even the most hard-nosed theoretical or applied neuroscientist. It is a book that is a must for every physician and every neurologist. Without question it should be part of the library for the medical student for whom a holistic appreciation of disorders and of patient management is often fragmentary at best. The realization that neural neurochemical, and other organic functions and dysfunctions can be altered without drugs or invasive procedures is found to upset the uncritical and complacent among us. All the better. This work is highly recommended as well for psychiatry, psychology, nursing, rehabilitation, and allied health personnel and agency officers who work with epileptics and their families. The distinguished editors as well as the publisher deserve our praise and thanks for a wellproduced and useful--if perhaps at times controversial and provocative--monograph.
pages) do not distinguish themselves particularly for the presentation of truly new information. (It would have been nice to learn how magnetoencephalography has affected the surgical developments, if at all.) Indeed, many (if not most) of the authors are familiar and they have written on this or similar themes in the past. In addition, for a work that carries a copyright date of 1994, it already borders on being dated. Except for a handful of citations (and a small handful at that) the references are several years old. For the specialist who has followed this area, therefore, the value of the writings may be questioned, yet it will certainly be appreciated as a useful introduction to a range of issues and as a means of gaining entry to the relevant literature. It is a nicely produced and illustrated work, incorporating quite a bit of emphasis on neuropsychology, surely a legitimate spin of an editor's prerogative. It might have been helpfulif the editors explained why they provided sample questionnaires and intake survey instruments (and how to make use of the information once received) that are provided as appendices. Even the neuropsychological and psychiatric aspects have not grappled with deficits other than language or emotion, nor was there any serious discussion of surgery with adult and perhaps geriatric patients. All in all, the editors are to be commended for enriching the epilepsy literature with this entry on epilepsy for the 1990s.
Ralph L. Carasso, M.D. Department of Neurology Hillel-Jaffe Hospital Hadera, Israel
David I. Mostofsky, Ph.D. Boston University Boston, MA, U.S.A.
The Surgical Management of Epilepsy, edited by Allen tL Wyler and Bruce P. Hermann. Stoneham, MA: Butterworth-Heinemann, 1994, 277 pp. Price: $75.00. If it suggests a restrictive treatment of surgical aspects of epilepsy, the title will have done something of a disservice to an otherwise useful edited volume that is far more comprehensive. At least 4 of the 22 "chapters" are concerned with psychiatric and general issues of the epilepsies. Certainly, this is not meant as a complaint, for it is encouraging that the editors of a monograph on surgical issues have recognized the need for addressing more than mere technological problems and solutions. Without question, this is a book that should be found in the library of every clinician concerned with epilepsy, especially every clinician in training. The various chapters (with an average length of six
250 J EPILEPSY, VOL. 7, NO. 3, 1994
Neurological Manifestations of Systemic Diseases in Children (The International Review of Child Neurology), Avraham Steinberg and Yitzchak Frank. New York: Raven Press, 1992, 399 pp. Price: $95.00. This book brings a long-awaited, comprehensive review of pertinent topics regarding systemic disease to pediatrics and neurology. Each chapter is organized according to the organ system primarily involved, allowing a rational access to information in pathophysiology, epidemiology,.and clinical manifestations of both neurological syndromes and underlying disorders. The data base is extensive, relatively recent, and largely draws from well-documented studies, providing consultants with reliable and accessible information. The pediatric viewpoint emphasizes the effects of disease on the developing brain in both the prenatal and postnatal periods. Malnutrition and neurological development, congenital malfoimations, and HIV