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An apology.

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the electrophysiological and molecular aspects of pathological
pain. It is written at a level that can be of great value to both
basic scientists and clinicians. The conciseness of the presentations and the clarity of the concepts makes it invaluable to
those readers who want to keep up with the science but do
not have time to go over the original data.
Ricardo A. Cruciani, MD, PhD
New York, NY
Complementary and Alternative Therapies for Epilepsy
Edited by Orrin Devinsky, Steven Schachter, and Steven Pacia
New York, Demos Medical Publishing, 2005
330 pp, illustrated, $79.95
Complementary and Alternative Therapies for Epilepsy covers a
broad range of complementary and alternative medical
(CAM) approaches to epilepsy care from biofeedback and
the ketogenic diet to osteopathy and pet therapy. The chapter authors vary substantially in their background and expertise. Each chapter is accompanied by a commentary from the
editors. The level of scientific sophistication and evidence
base for individual chapters range broadly. For example, details regarding study design are in general too simplistic to
offer much to a physician-reader and may be more appropriate for a lay audience (one exception being an excellent table
in Chapter 2 detailing the language for indicating who was
blinded to the intervention in various study designs). Unfortunately, if details from some chapters are taken out of context or without the counterbalancing commentary from the
editors, serious misinformation might be propagated. Frequently, potentially dangerous side effects of CAMs are not
mentioned at all by the chapter authors and are covered only
in the editors’ commentary.
Whether randomized controlled trials (RCTs) can adequately assess CAMs is discussed in Chapter 2, and it is acknowledged that this may not be the case. But no alternative
method of assessing CAM is offered and the reader is left
feeling somewhat uncertain how to judge what is presented.
Repeatedly the valid point made by the editors in their commentary is that any intervention that decreases patient stress
may have an impact on seizure frequency.
Several chapters offer anecdote and trials of “N ⫽ 1” as
proof of efficacy. When potential mechanisms of action for a
CAM are discussed, problems with the logic of the causal
chain are not acknowledged. Unsubstantiated claims are frequently stated as fact and references from some chapters are
entirely composed of non–peer-reviewed publications from
the chapter’s author. Chapter 25 The Role of Carbon Dioxide in the Enhancement of Oxygen Delivery to the Brain
seemed to be entirely made up of propaganda for the Institute for the Achievement of Human Potential. This chapter
described getting children with epilepsy off of antiepileptic
drugs (AEDs) as “detoxification” and apparently the Institute
makes this their primary goal.
Some topics for which Complementary and Alternative
Therapies for Epilepsy might have offered important new insights to patients and their families are missing. For example,
the chapter on stress and epilepsy fails to address nonepileptic psychogenic seizure. In fact, these are not discussed any-
where in the text. If Complementary and Alternative Therapies
for Epilepsy is intended as a source of information for the
layperson, it might have been an ideal forum for a sensitive
presentation of nonepileptic psychogenic seizure. Those
chapters that deal with neurobiofeedback and seizure triggers
clearly aim at empowering people with epilepsy (PWE) to
take “control” of their seizures wherever possible. But the
message could easily leave PWE feeling somehow responsible
for the “lack of seizure control.”
Some chapters provide a particularly good background
and overview of topics offering significant value to physicians
interested in alternative medicine. These include coverage of
homeopathy, naturopathy, and ayurvedic medicine. The
chapter on hormonal medicine is excellent. Two chapters
provide in-depth discussion of the potential mechanisms of
actions for herbal remedies as well as extensive coverage of
the possible AED–herbal medicine interactions. These chapters alone warrant putting Complementary and Alternative
Therapies for Epilepsy on your bookshelf.
The editors deserve congratulations for their presentation
of CAM for epilepsy in a comprehensive text with some
evidence-based and scientific oversight. However, the appropriate audience for Complementary and Alternative Therapies
for Epilepsy is unclear, and one must be concerned that the
lay reader could inadvertently or intentionally choose to ignore the editorial comments, which could result in some serious harm.
Gretchen L. Birbeck, MD, MPH
East Lansing, MI
An Apology
To the readers and the Editor: I am writing this letter
to convey my sincerest apologies and deep regret for
my inadvertent error in our article published in the
June 2005 issue of the Annals of Neurology (Ann
Neurol 2005;57:874 – 882).
In the discussion section, parts of our article were
taken from a Neurological Progress article published in
the September 2002 issue of the Annals (Savitz et al,
Ann Neurol 2002;52:266 –75).
But, I failed to notice that the original source (Dr.
Savitz’s article) of some of the text was omitted in the
reference section. Omitting Dr. Savitz’s invaluable article as a reference was a grievous error, but this was an
inadvertent and unintentional mistake.
Now I am guilty of putting my colleagues in a very
embarrassing situation due to this unintentional error.
I deeply regret the anguish caused to the readers and
the Editor, and to Dr. Savitz due to this unintended
plagiarism on my part.
With sincerest apologies,
O. Y. Bang
Department of Neurology
Ajou University
Suwon, South Korea
DOI: 10.1002/ana.20690
Annals of Neurology
Vol 58
No 2
August 2005
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