Biological Factors in Temporal Lobe Epilepsy

Abstract

Neurology receives scant treatment in standard paediatric textbooks.Publications in the excellent series, Clinics in Developmental Medicine, have done much to remedy this.The latest addition, double volume 20/21, ably fills another gap.Despite the traditional high standard of adult neurology in Britain, paediatric case notes in this country rarely contain a systematic neurological examination.Richmond Paine and Thomas Oppe have effectively removed any excuse for this.History taking directed towards a neurological child patient is first described.This is followed by a useful chapter on 'some particular symptoms', e.g.involuntary movements, floppiness, pica, which brings together information previously only available in original papers.A routine scheme of central nervous system examination is outlined.In succeeding chapters, the component parts of this examination are dealt with in very consider- able detail: ranging through assessment of mental state, speech, cranial nerve function, gait, motor function, reflex activity, sensation, and autonomic function.Practical details, special tricks and manoeuvres necessary at different ages are given, with information on the range of normal, and the age at which co-operation in the various tests can be expected.However, this volume is far more than a handbook on examination technique, the implications of abnormal signs are fully discussed, and the authors have succeeded well in their 'hope of bridging the gap between mere techniques of examination and the making of an anatomical and aetiological diagnosis'.The section on infantile automatisms and their interpretation is particularly succinct.There is an interesting and informative chapter on special tests of cerebral function, in which it is stated, but perhaps insufficiently stressed, that very considerable experience is required in the giving and interpretation of these tests which would normally be carried out in conjunction with a clinical psychologist.The last chapter gives an up-to-date review of special investigations; again many would presumably be done in special centres in conjunction with consultants in other specialities.The illustrations are well chosen and clear.This book is highly recommended to all established and aspiring paediatricians, and to neurologists who examine children.It should be available to post-and undergraduate students in teaching hospital libraries.