Intractable Seizures: Diagnosis, Treatment, And Prevention, edited by W. McIntyre Burnham, Peter L. Carlen, Paul A. Hwang
This book takes as its subject one of the more frightening sort of health problems that people can deal with as either sufferers or medical practitioners, and that is seizures that are intractable, that is, which are not helped by medication. Given that medications are the first line of offense in the arsenal of contemporary medicine against any kind of health problem, the presence of a serious and even crippling health problem that proves itself resistant to such treatment is very alarming indeed. And thus this book is written about an area that the authors involved clearly believe is very important and serious. This focus and interest keeps the book focused on trying to be of help to the people with such conditions to the best degree of the knowledge of the authors, and even though I do not agree with the intense focus on medicine and surgery to the exclusion of other solutions, I give a great deal of benefit of the doubt tot those whose interest in improving the health of those with serious problems is sincere even if their knowledge and attention is incomplete, as is the case here.
This book is a little less than 250 pages long and it is divided into 21 papers in a variety of unnumbered sections. The first paper discusses intractable epilepsy in adults (1). After this there are three papers that discuss the diagnosis (2), drug therapy (3), and surgery (4) for complex partial seizures. Perhaps unsurprisingly, the next three papers then discuss the diagnosis (5), drug therapy (6), and surgery (7) for West’s syndrome, which is marked by infantile spasms. Again equally unsurprising, the next three papers discuss the diagnosis (8), drug therapy (9), and surgery (10) for Lennox-Gastaut Syndrome. A paper then follows on the special topic of the comparison and contrast of early and late surgical intervention in intractable seizures (11). Three more papers discuss basic pyschopathy, asking why complex partial seizures are intractable (12), discussing the psychopathy of infantile spasms (13), and then discussing the functional properties of human neocortical neurons (14). After this comes three papers on the effects of unchecked seizures based on human (15, 16) and animal (17) studies. Finally, there are four papers on new therapeutic methods, including papers on Landau-Kleffner syndrome (18), neuroprotective strategies in epilepsy (19), the ketogenic diet (20), and vagal stimulation (21), after which the book ends with an index.
It should be noted that one of the things that raises this book above the norm for the type of book it is comes in the last section of the book, which deals with “new” treatments for seizures that are resistant to medicines, which includes the ketogenic diet, vagal stimulation, and neuroprotective strategies. While these particular methods are not necessarily anything that will be unusual to those who have had to deal with seizures, they are not the sort of treatments that mainstream doctors have always been quick to recommend, although when medications are not effective, other treatments must be considered. It is somewhat telling that these non-surgical treatments are relegated to the back of the book, but it is praiseworthy that they are included at all. Even so, a book like this often reveals the mindset of the people writing it, and it is worthwhile to ponder why it is that certain solutions are often recommended as opposed to others and what the costs of these are. To the extent that we rely on magic pills and drastic surgical interventions to deal with health problems, we ensure that there will be a great deal of expense in treatments, as opposed to other means that may preserve health with fewer side effects and at lower cost.