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Medical risks in epilepsy
  1. Lina Nashef

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    Edited by Svein I Johannessen, Torbjörn Tomson, Matti Sillanpää, and Birthe Pedersen (Pp 140, £29). Published by Wrightson Biomedical Publishing Ltd, Hampshire, 2002. ISBN 1- 871816-46-7

    This is a very useful, reasonably comprehensive yet succinct multiauthor small book on medical risks associated with epilepsy. Areas covered include methodological aspects; accidents and risks in everyday life; traffic accidents; driving regulations; mortality, including SUDEP; psychiatric comorbidity and suicide; fatal adverse drug reactions reporting data (which are rather difficult to interpret); seizure-warning systems and risk prevention; as well as insurance related issues. It also highlights many areas where further research is required. The book generally provides an overview of the more recent research and publications in this area and includes some regulatory issues. Inevitably it has a Nordic emphasis; it includes very useful advice on precautionary measures to minimise risk of injury for people with uncontrolled epilepsy, including safer sauna. Some chapters, by necessity, serve purely as a compilation of available incomplete data. Others are written by key researchers directly involved in the area addressed and provide a very balanced review of current knowledge. On psychiatric comorbidity, while agreeing that “the positive effects of drug therapy on cognitive and affective functioning because of the reduction in seizure activity are usually far greater than the negative effects”, more information would have been welcome in an otherwise very well balanced chapter. The book would well serve those for whom it is intended, namely epileptologists, neurologists, paediatric neurologists, psychiatrists, and other professionals who deal with patients with epilepsy. The editors rightly stress the “official line” that the majority of patients with epilepsy can achieve good control, with low associated risks.

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