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In recent years there has been a significant increase in the number of children who are investigated as potential candidates for epilepsy surgery, and in the number of centres which offer this service. Some of the reasons behind this are improved access to high resolution MRI and other techniques for the assessment of the origins of epilepsy, an increased level of awareness and expectation among parents, and acceptance by paediatricians and paediatric neurologists of the potential benefits of surgery in carefully selected cases.
Epilepsy surgery was developed to a large extent in adults. Traditionally it was offered to children only as a last resort, principally because of the understandable reluctance to remove or disconnect parts of the brain for anything other than life threatening pathology. The recent interest in childhood epilepsy has come about largely because of a better understanding of the natural history of epilepsy, declining surgical morbidity, and the potential which exists for improved cognitive and behavioural outcome from early control of seizures.
Against this background, Tuxhorn and colleagues have produced this book. Although generated as a result of the 6th International Bethel-Cleveland Epilepsy Symposium, this is not a book of the conference proceedings. Instead, many acknowledged experts in the field have combined to create a comprehensive and integrated account of the current status of paediatric epilepsy surgery. The book is divided into 11 sections which cover the range of clinical syndromes; cognitive and psychiatric aspects of childhood epilepsy; failure of medical treatment; presurgical evaluation; ethical issues; and finally the full range of surgical procedures, their outcomes, and complications. The chapters are succinct, well referenced, and consider contentious issues in a balanced manner.
This book will be invaluable to both expert and non-expert clinicians alike who are involved in the care of these patients. It will be of particular interest to paediatricians and neurologists referring patients to specialist centres, to those with ambitions to start up their own paediatric epilepsy programmes, and as a reference work for those already established in the field. It is to be commended.
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