Epilepsy in clinical practice. A case study approach. Edited by ANDREW N WILNER (Pp272, US$34.95). Published by Demos Medical Publishing, New York, 2000. ISBN 1-888799-34-x.
This is an interesting book, directed at a wide audience including neurologists, medical students, social workers, and pharmacists, which sets out to demonstrate the management of epilepsy in practice by presenting case histories of people with seizures. The issues addressed include such common clinical difficulties as diagnosis (and the problem of non-epileptic attacks), epilepsy in pregnancy, withdrawal of antiepileptic drugs, and status epilepticus. Alternative therapies and psychiatric issues are also discussed. Each history is followed by questions about the management of the patient, which the author answers according to his practice, with appropriate explanations. The second part of the book consists of a sizeable Resources section providing such diverse information as the classifications of epileptic seizures and syndromes, seizure history checklist, home safety checklists, lists of drugs and their modes of action, websites for physicians and patients, lists of epilepsy centres, and driving regulations within the United States.
Both sections of the book contain a wealth of information, and the histories, which are easy to read, provide a useful insight into the problem areas of epilepsy, together with possible solutions. Inevitably the views given describe the authorís personal practice, and the nature of the book does not allow detailed examination of the evidence underlying the decision making. However, it emphasises the importance of tailoring treatment to the individual patient, and addresses the social issues in a manner often missing from larger texts. I found the fact that the book was clearly directed at an American audience, which was apparent not only in the Resources section, but also colouring the choice of medication and the advice given (for example, on driving), somewhat distracting. Nevertheless, it should prove useful reading for those involved in the care of people with epilepsy.
Journal of Neurology, Neurosurgery, and Psychiatry