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Edited by Sheila Wallace, Kevin Farrell. Arnold, 2004, £120.00 (hardback), pp 485. ISBN 0 340 80814 4
Management of epilepsy in children can be complex and challenging and a good clinician knows when to draw on multidisciplinary professional expertise, while staying up to date with clinical and non-clinical areas outside his or her immediate expertise. No one understood this more than the late Sheila Wallace under whom I had the privilege to train in the 1980s. She was a hands on clinician who did not shy away from basic science. The first edition of her book, Epilepsy in children, published in 1996, not surprisingly encompassed the various disciplines involved in the understanding and management of epilepsy, and became a popular reference text. When I picked up the second edition, now edited by Sheila Wallace and Kevin Farrell, I knew the book would be good reading, but would it be better and worth shelling out another £120.00? The short answer is yes.
As in the first edition this book covers all aspects of epilepsy in children with additional contributing authors reflecting the international collaboration. There is also a distinct change in style to include the modern trend of boxes with key points at the end of each chapter, and tables allowing brevity of text. At times there is a price to pay for the brevity. For example I was disappointed that the initial chapter did not include the old classification of seizures and epilepsy syndromes, when the new classification is only a proposal and authors in the text continue to use the old terms. Similarly the chapter on chromosomal syndromes only touched on disorders, even when epilepsy is the major presentation, such as in ring chromosome 20. There are however many chapters of substance covering pathology, pathophysiology, neuropsychology, and neuroimaging, in addition to the various age dependent epilepsy syndromes and lesional epilepsies including following brain injury. The chapter on psychiatric and cognitive aspects of epilepsy, areas often neglected or left to other professionals, are a must reading for paediatricians developing an interest in epilepsy and the more experienced clinician. Treatment of epilepsy including surgery and management of status epilepticus is well covered, though for the UK reader it is unfortunate that while the ketogenic diet is included, there is no mention of the modified ketogenic diet offered in our centres.
In the first edition Sheila Wallace tackled the chapter on neurophysiology herself, but rightly invited neurophysiologists to contribute for this edition. These authors provide an excellent overview of the normal and abnormal EEG patterns for the clinician, with super clarity of EEG samples included with the text. The chapter would have been enhanced by clearer guidelines on the use of the EEG, especially the value, if any, of repeat interictal EEG recordings in the management of children with epilepsy, covering issues related to drug withdrawal, cognitive deterioration, etc. Though the EEG is a valuable and relatively inexpensive tool, its limitation is not always appreciated.
With the proposed establishment of epilepsy networks in the UK and the expectation for a named paediatrician in each district general hospital with an interest in epilepsy, this book is well placed to be a valuable addition to departmental paediatric libraries and also an informative reference source for the paediatric neurologist.