Child Neurology Department, Hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France.
- Page(s) : 75
- Published in: 2000
This monograph is a comprehensive study of the benign epilepsies of childhood that constitute a sizable part of the epilepsies encountered in everyday practice by paediatricians, neurologists and clinical neurophysiologists who care for children with seizures. The author rightly underlines that these syndromes are both a fascinating and a rewarding topic in paediatric epileptology.
Panayiotopoulos starts with a reminder of the concept of epilepsy syndrome and an excellent review on the significance of the EEG in the diagnosis and management of the epilepsies. He then describres in considerable detail the main benign epilepsy syndromes beginning with benign rolandic seizures, then dealing with the various forms of benign occipital seizures and their differentiation from migraine. The book ends with the description of some less common benign seizures syndromes.
For each syndrome, the author gives a complete account of the historical aspects of each syndrome with extensive quotations from the most important original articles. The clinical description of the clinical EEG features of the syndromes is superb and the relevant literature is exhaustively reviewed (the reference list includes over 830 items). Case reports drawn from the extensive experience of the author are appended thus giving a personal flavor to the descriptions.
Two chapters are dedicated to benign rolandic epilepsy and the problems posed by the presence in tracings of centrorolandic spikes with and without seizures and lucidily consider the significance of this finding and its relationship with conditions other than epilepsy, with age of occurrence and with associated EEG abnormalities. There is also an informative section on ictal EEG in this syndrome.
The chapters on benign occipital epilepsy, a field in which Panayiotopoulos has long been a pioneer, are particularly developed and their clinical presentation and course carefully reviewed. The author gives precises criteria for differentiation of the early type from the late-onset form, from photic-induced benign occipital epilepsy and from the symptomatic and probably symptomatic forms. This nosological discussion is richly documented with an abundance of personal examples of the different types. There is a very good chapter on the occipital EEG paroxysms both in children with occipital epilepsies and in those without seizures and a review of the reflex epilepsies triggered by visual stimuli.
Because of the frequency of headaches and/or vomiting in occipital epilepsies, Panayiatopoulos reviews in detail the differential diagnosis between epilepsy and migraine, a theme to which his contribution has been important. I found the exposition of this usually rather murky topic illuminating and the criteria for distinction between these two conditions are undoubtedly of great practical value.
The rarer syndromes of partial benign epilepsies of different localization (e.g. frontal, parietal and temporal) and their still uncertain nosology are adequately discussed.
The last chapters on severe syndromes possibly related to the benign partial epilepsies, namely the Landau-Kleffner syndrome and the syndrome of continous spike-waves of sleep are less exhaustive than those of the benign types and the discussion of the nature of their relationship to the more usual types is somewhat perfunctory. These syndromes clearly do not belong to the benign partial epilepsies proper but the problem posed by their relation to typical rolandic spikes and the question as the whether they can be predicted early in the course of the epilepsy is not dealt with.
Likewise, I believe that the recently described types of dominantly inherited, partial epilepsy such as frontal nocturnal and temporal familial epilepsies deserved at least a brief mention, even though the available information is still limited, the benign uncertain nature and the age of occurrence not limited to childhood.
Panayiotopoulos’book will remain a landmark in the study of the benign partial epilepsy by its completeness, lucidity and original documentation. It is of major interest for all those who see children with these common, yet often misdiagnosed and mismanaged syndromes, whether epileptologists, neurologists, paediatricians or clinical neurophysiologists who will have many occasions to use it and will find it useful on their bookshelf.
Panayiotopoulos CP. Benign Childhood Partial Seizures and Related Epileptic Syndromes. London, Current Problems in Epilepsy: 15, John Libbey & Company LTD; 1999.
Books proposed for review can be addressed to the Supplement Editor:Dr Arzimanoglou A. Child Neurology Department, Hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France.