Clinical Management Of Seizures: A Guide For The Physician, by Gail E. Solomon and Fred Plum
It is striking to consider the state of seizure knowledge in the mid 1970’s and to ponder its connection to such matters nowadays. This book is not written for the lay audience, but that’s fine as it is certainly accessible enough for those who know people who have had to deal with seizures, and who can be baffled by the many different connections relating to seizures and other connections. It must frequently be remembered that seizures are themselves a symptom, albeit a very unpleasant one, and understanding the etiology of the seizures is of vital importance in preserving the health of someone suffering from them, as there are a wide variety of treatments that can be effective but they depend on correctly diagnosing where the seizures come from, as the help that is needed for someone who is epileptic would be quite different from someone whose seizures spring from hypoglycemia or alcohol abuse, for example. The authors do a good job in providing a discussion of seizures that is highly interesting and also likely very useful people who have a practical purpose for it.
This book is a bit less than 150 pages and is divided into seven chapters. The book begins with an introduction that discusses the history of seizures and their understanding as well as definitions and etiology (I). This is followed by a chapter that discusses physiology and metabolism and their role in seizures (2), as well as a longer chapter that discusses the massive variety of types of seizures that one needs to distinguish between, including neonatal seizures, grand and petit mal epilepsy, focal cerebral epilepsy, minor motor seizures, as well as various unusual variants of seizures that do not fall into any of the previous categories (3). After this comes a discussion of a clinical work-up for a patient with seizures (4) as well as a differential diagnosis for seizures that can easily be misunderstood for epilepsy and which require a different treatment, including the fondness for the authors for psychotherapy (5). After that come chapters that discuss the general treatment of epilepsy (6), namely medications and surgery, as well as the social, behavioral, and medical problems of epilepsy that include disturbances, aggressiveness, sexuality (usually hyposexuality), intelligence, education, recreation, as well as the prohibition of those with epilepsy in the armed forces or driving and organizations that aid people with that condition. The book ends with a selective bibliography and an index.
It is hard to understand the connotations that are meant when one deals with matters of seizures. A great many seizures are connected with brain damage, and anyone who is self-respecting and wishes to be well regarded for intellect would be rather chary about admitting a seizure past. Even to this day, seizures cause a significant stigma, including being prohibited from participating in medical test. Be that as it may, the authors do a sound job of seeking to disentangle the various ways that can result in seizures, along with an expectation of either surgery or medication as being the solution to this, which is striking and odd considering the lack of interest in solutions that do not come in these packages. While these would not correspond with my own views, they certainly do represent the sort of solutions that appeal the most to medicine, something that is not any different nowadays than it was more than forty years ago when this book was written. The reader who does not approach this book or this subject from the point of view of medical practice may ponder why it is focused on such directions as it is and to ponder what other solutions, perhaps of lower cost and side effects, may be worthwhile in addition to or instead of what this book recommends.