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Diagnosis and management of neonatal seizures. By Eli M. Mizrahi and Peter Kellaway Philadelphia Lippincott-Raven 1998 192 pp illustrated $79

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Review
Diagnosis and Management of Neonatal Seizures
By Eli M. Mizrahi and Peter Kellaway
Philadelphia, Lippincott-Raven, 1998
I92 pp, illustrated, $79.00
Seizures remain one of the few neonatal neurological emergencies that may reflect significant dysfunction or damage to the
immature brain; diagnostic and therapeutic plans should be established promptly. Drs Mizrahi and Kellaway have written an
excellent textbook to serve as a guide to the controversies regarding the diagnosis, pathogenesis, and treatment of neonates with
seizures. As they have stressed in their preface, a full text regarding this subject has been needed, and their efforts reflect a firm
foundation upon which new research hopefully will be generated
and disseminated. Criticisms that could be cited with respect to
specific topics are indeed secondary to the overall importance of
a clearly written discourse by leaders in the field with respect to
this important clinical problem. Electroencephalographic (EEG)
and polysomnographic studies are invaluable tools for the assessment of suspected seizures, and the authors are highly qualified
to incorporate a discussion of classification, diagnosis, and management using these important bedside neurophysiological tools.
Diagnosis and Management of Neonatal Seizures is organized
into nine chapters following a logical sequence of discussion in
terms of clinical significance, incidence, and epidemiology, classification, pathophysiology, etiology, therapy, prognosis, neonatal EEG, and EEG/polygraphic/video monitoring. Clearly written tables and flow charts amplify the text in each chapter. The
authors introduce a classification system, emphasizing the use of
the EEG to distinguish between epileptic and nonepileptic neonatal seizures, adopting a pragmatic approach to document an
ictal pattern by surface EEG recordings. Their discussion emphasizes a need for a more integrated approach to the classification of neonatal seizures. As neurophysiological monitoring
technologies improve, the ability of neurophysiologists to distinguish subcortical epileptogenesis from a nonictal brainstem release phenomenon can be addressed more accurately. In their
discussion of the presumptive causes of neonatal seizures, recognition of the diverse medical conditions that may be associated
with seizures is emphasized clearly for the reader. Greater emphasis in a future revision may be helpful concerning anteparturn medical conditions of the mother, placenta, or fetus which
may contribute to a neonatal encephalopathy with or without
seizures. An excellent discussion of treatment modalities as well
as the efficacy of using antiepileptic medications is offered. The
more recent use of free and drug-bound fractions could have
emphasized the efficacy as well as potential toxicity of antiepileptic drugs in the neonatal population. Apart from these minor
suggestions, the authors have succeeded in offering us a timely,
thoughtful, and provocative evaluation of an important problem
in fetal and neonatal neurology. All readers interested in the care
of the neonatal patient will enjoy the comprehensive manner in
which the authors have examined this medical topic.
Mark S. Scher, M D
Cleveland. OH
988
Received
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Cell Transplantation for Neurological Disorders:
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Epilepsy and Other Neurological Disorders in Coeliac
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Salvatore Naccarato, and Giacomo Banchini
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New York, Oxford, 1998
449 pp, illustrated, $85.00
Copyright 0 1998 by the American Neurological Association
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kellaway, illustrated, philadelphia, management, 192, eli, 1998, lippincott, seizure, rave, peter, neonatal, diagnosis, mizrahi
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