The Comorbidities of Epilepsy: Book Review
Posted in Book Reviews on 20th Feb 2020
Edited by: Marco Mula
Published by: Academic Press, Elsevier 2019
Reviewed by: Dr Ann Donnelly.
Published online: 20/2/20
This book shares a title with the one-day course, which Dr Donnelly has also reviewed here.
The Comorbidities of Epilepsy is a sweeping view of the myriad links between epilepsy, and multiple aspects of health. Edited by Marco Mula, it has the support of the International League Against Epilepsy (ILAE), with a foreword from the president. The chapter authors are international, predominantly from Europe and North America, all highly regarded within their fields. This book is clearly the result of tireless excavation and subsequent pulling together of the existing evidence base for many disparate areas relating to epilepsy. It has 19 chapters, addressing the hinterland of areas such as obesity, cancer, bone density as well as more familiarly trodden areas such as psychosis and depression in patients with epilepsy.
Many chapters immerse us in the historical basis of our current thinking, and methodically bring us up to date, where the evidence base is often weak. Using case reports to provide a balanced view on each subject, it provides rigour and depth of knowledge about areas which are often skimmed over in clinical practice, if broached at all.
Before reading, the interaction between epilepsy/anti epileptic drugs and cancer or inflammatory bowel disease was not something I have previously considered. The exhilarating feeling of seeing familiar areas, obesity, cardiovascular disease, bone health, and cancer, through a refreshing new lens, when related to epilepsy, recurred throughout my reading of this book. It provided pause for reflection in every chapter, and a paradigm shift occurred within me.
Who is it for?
The myriad ripple effects of Epilepsy and its management are explored in detail, and the subjects are of relevance to all professionals who care for patients with epilepsy, including specialist nurses and general physicians.
This is not a companion book. It could not be carried around easily, and its ‘dippability’ factor (can I dip in for 5 minutes here and there and easily access information?) is moderate. The text is dense with sparse illustrations or diagrams, although the images provided are beautifully presented. The text is well formatted, in a way that I found easy to read, and to follow. End of chapter summaries with key highlights would have enhanced my experience of this.
The weakness of any academic textbook, is the fear that the evidence can date quickly. Many clinicians prefer to go first to recent reviews in clinical journals when updating knowledge (especially as there is a lack of shelf space). This is where the book comes into it’s own. It is unique in its perspective, enriched by evidence, each chapter is a detailed review of where we are at present. I sense that many of the areas are not rapidly evolving and this book will remain a good foundation for further reading for many years to come.
In summary, The Comorbidities of Epilepsy was a joy to read, and provided new knowledge, as well as enhancement of existing knowledge when considering psychosis in epilepsy. It widens the view of how the patient with epilepsy is affected by their diagnosis, and how we can acknowledge that and help in a comprehensive way. Having read it, I feel empowered to ‘add value’ to my consultations with patients with epilepsy by facing these additional areas. By diagnosing sexual function and cognition, and to wander away from the safely trodden script focused on seizures alone.
Having read it in detail over the last few months, will I continually return to it? Time will tell. I conclude that I will return to it time and time again, for teaching preparation and for enhancement of my clinical consultations.