Cognition and Behavior in Childhood Epilepsy

Lagae L, ed. Cognition and Behavior in Childhood Epilepsy. London: Mac Keith Press; 2017(192pp). List price: $65 (US). ISBN 9781909962873

The cognitive and behavioral sequelae of childhood epilepsy are relatively under explored. In a busy clinical setting, clinicians are often most concerned about a patient's seizure frequency, type(s) and duration, medication compliance, and medication side effects. The more elusive cognitive and behavioral aspects of a child's life and function, so important to the child and family, may receive less attention. Nevertheless, for families, the psychosocial burden of epilepsy may be more concerning than the seizures themselves. It is widely recognized that epilepsy is composed of far more seizures—epilepsy can be conceptualized as an iceberg, with seizures representing the part of the iceberg above the water's surface, while the behavioral, cognitive, and emotional concomitants represent the part of the iceberg below the water—unseen but massive in significance and importance. Acknowledging that our management options for these neuropsychiatric problems are few and nonspecific, it is crucial to pay attention to these wider phenotypic manifestations of childhood epilepsy.

These topics are discussed head-on and elaborated in this thin but weighty volume. The editor has assembled a remarkable slate of international experts who provide a coherent and comprehensive approach to the psychosocial aspects of childhood epilepsy. In less than 200 pages, this book presents up-to-date data and concepts about the prevalence, types, and treatment options for epilepsy cognitive comorbidities. The first several chapters provide an introduction to the role of neuropsychological testing and how such information can be interpreted, the interaction between cognition and behavior in epilepsy, the use of functional imaging to investigate comorbidities, and some of the potential underlying pathophysiological factors involved in interictal and ictal discharges with regard to cognitive processing. The book then launches into several chapters exploring specific childhood epilepsy syndromes and how behavioral and cognitive comorbidities can be syndrome specific. Examples include neonatal seizures, the benign epilepsy syndromes of childhood, infantile spasms, Dravet's syndrome, continuous spikes and waves during slow-wave sleep, and Lennox–Gastaut syndrome. These in-depth discussions provide the reader with extremely useful, practical insights into how and why of cognitive impairments as a function of epilepsy syndrome. Finally, the role of epilepsy surgery in improving cognitive and behavioral outcomes is explored. While additional schematics and figures would have added luster to the text, I found each chapter quite readable and clear.

In this modern era, with the availability of online resources, open access journals and the like, the question arises as to whether a printed book such as this one still has a role. My strong opinion is the affirmative—having so many expert opinions of thoughtful clinicians and researchers in my hands, in one place, with the ability to quickly scan so many important topics by flipping a few pages—more than warrants the modest cost of this volume.