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Book Reviews
Sep 2012

The Causes of Epilepsy: Common and Uncommon Causes in Adults and Children

Author Affiliations


Author Affiliations: Department of Neurology, University of Washington, Harborview Medical Center, and Regional Epilepsy Center, Seattle, Washington.

Arch Neurol. 2012;69(9):1212-1213. doi:10.1001/archneurol.2012.1266

edited by Simon D. Shorvon, MA, MD, FRCP, Frederick Andermann, OC, MD, FRCPC, and Renzo Guerrini, MD, 787 pp, $195, ISBN 978-0-5211-1447-9, New York, New York, Cambridge University Press, 2011.

Many dozens of textbooks on epilepsy have been published within the last several years, but none have focused specifically on the causes of epilepsy. In one sense, this may be a surprising observation because epileptic seizures are among the most common of neurological conditions. However, from another perspective, this is quite understandable because the assembly of a compendium that comprehensively details the enormous number of potential etiologies of the epilepsies and epileptic seizures must be a monumental task. Yet the editors of this book, along with a large and distinguished international group of contributors, have succeeded in accomplishing this mission, with the end product being a truly unique text.

The text begins with a historical review, followed by succinct discussions on the mechanisms of epileptogenesis in the idiopathic and symptomatic epilepsies. The structure of the book is then logically developed in the subsequent 106 individual chapters. One of the strengths of this book is its emphasis on recent developments in molecular biology and genetics as applied to the etiology of epilepsy, and the first few chapters discuss the concept of idiopathic (genetic) epilepsy followed by a review of “pure” epilepsies known to be due to single gene disorders and those for which a more complex inheritance is presumed. The bulk of the textbook, as might be expected, is devoted to the causes of the symptomatic epilepsies, and even in this setting, as throughout the book, research findings that implicate the likely contribution of molecular genetic, biochemical, or chromosomal derangements are emphasized. After a general discussion of the symptomatic epilepsies and epilepsy syndromes, individual chapters are devoted to the progressive myoclonic epilepsies, neurocutaneous syndromes, other single gene disorders with epilepsy as a prominent symptom, chromosomal disorders, cortical dysplasia, hippocampal sclerosis, perinatal disorders, cerebral trauma, cerebral neoplasm, central nervous system infections, cerebrovascular disease, immunological disorders, and psychiatric, demyelinating, and degenerative disorders as causes of epileptic seizures. The next section of the book includes discussions of the “provoked” epilepsies, such as those associated with general medical conditions, substance abuse, and toxins. The reflex epilepsies are then reviewed, and chapters in this section outline the variations of reflex seizures and their likely etiologies. Finally, the text concludes with a section on status epilepticus, with individual chapters devoted to presumed mechanisms and causes of status in adults and children, and in convulsive and nonconvulsive states.

Each condition known to be a cause of epilepsy includes a detailed discussion of etiology, followed by a variable overview of clinical manifestations, and, depending on the specific disorder, the associated neuroimaging, electrographic, laboratory, and pathologic findings, and, when appropriate, available treatment options. As with any multiauthored textbook, individual chapters show some variation in the quality of content of the discussion. Although the tables, photographs, and figures are, for the most part, very useful and, in fact, indispensable in many cases, there are some curious omissions and redundancies. For instance, with regard to illustrations of electroencephalographic findings, examples are presented for the electrographic findings in Rett syndrome and denatatorubral-pallidoluysian atrophy, both very uncommon causes of epilepsy. On the other hand, there are no electroencephalographic examples shown for benign partial epilepsy of childhood and none at all in any of the 4 chapters devoted to hippocampal sclerosis and prenatal and perinatal injuries, which are far more common causes of epileptic seizures. The choice of photographs must necessarily be selective, but the Kayser-Fleischer rings in Wilson disease are shown both in a pair of black and white photographs and in a pair of colored photographs, whereas there is no example of a Lafora body or of the inclusions found in one of the neuronal ceroid lipofuscinoses.

Overall, the criticisms are relatively minor and are outweighed by the positive aspects of this textbook. Virtually every known cause of epilepsy in both children and adults is reviewed, and the authors bring into the discussion the most up-to-date clinical data, technological advances, and research findings that pertain to etiology. This book will be of most use as a reference guide for epilepsy fellows and neurology residents, but experienced neurologists, including epileptologists, will also find it of great value.

Prose ★★★★
Illustrations ★★★
Science ★★★★
Usefulness ★★★★

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Article Information

Correspondence: Dr Holmes, Department of Neurology, University of Washington, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104 (mdholmes@u.washington.edu).

Financial Disclosure: None reported.