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Non-epileptic Seizures.
  1. Wessex Neurological Centre, Southampton General Hospital, Southampton, UK

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    Non-epileptic Seizures. 2nd Ed. Edited by John R Gates and A James Rowan. (Pp 323; £70 hardback.) Butterworth Heinemann, 2000. ISBN0-7506-7026-6. ***

    The editors of this book were successful in recruiting authors of three main disciplines—neurology, neuropsychology, and psychiatry—to cover such a difficult diagnostic and management problem.

    The book is divided into four parts and each ends with a helpful summary. The first part deals with the neurological aspects and differential diagnosis of non-epileptic seizures in both adults and children. Various chapters detail the relevant aspects in the historical features that suggest psychogenic seizures. The clinician is reminded not to miss unusual epileptic events with bizarre manifestations like frontal lobe seizures. The chapter on parasomnias is particularly helpful, detailing phenomena that can be confused with epilepsy. The only criticism I have to this part was the repetition of diagnostic lists provided.

    The second part, covering the use of neuropsychological testing to differentiate neurological from non-neurological disorders, is explained with some helpful medicolegal examples. Neuropsychological functioning and quality of life variables are all covered for both the epileptic patients and those with non-epileptic seizures.

    The third part is dedicated to the paediatric patient and covers cognitive, psychological functioning, and treatment of children with non-epileptic seizures. The differences between the adult and the paediatric patients are highlighted and the reader is also reminded that the non-epileptic attack in children may originate with the parent as a form of Munchausen syndrome by proxy. While the variety of psychotherapeutic approaches detailed may not be easy to follow by the non-psychologist and psychiatrist, advice on family and child education and mind-body connection are emphasised and made simple to read.

    The fourth part deals with the psychiatric aspects of patients with non-epileptic seizures and concludes with a chapter on treatment strategies.

    This book would prove helpful to all those managing epilepsy and of particular help to neurologists, neuropsychiatrists, and psychologists engaged in the assessment and treatment of patients with non-epileptic seizures.

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