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Media watch

Neurology Vol 3 August 2004 http://neurology.thelancet.com

Autism: Mind and BrainEdited by Frith U, Hill EOUP, 2004£29·95, 300 pp0 19 852923 6

From the haunting image of a young man onthe cover through the 13 chapters, there is a

sense of quality in this highly useful monograph on thecognitive underpinnings of autism. Uta Frith is one of thepioneers of modern autism research and she and coeditorElisabeth Hill have selected a stellar set of researchers to reviewthe field. First published as an issue of Phil Trans R Soc Lond B(2003; 358: 275–427), these papers are useful in book format.Autism research has undergone a great expansion and nowinvolves scientists from areas as diverse as molecular biology,immunology, gastroenterology, and neuroscience.

The chapter by Hill and Frith, “Understanding autism:insights from mind and brain” provides an excellent andhighly readable overview of the signs and symptoms of autism.Tager-Flusberg and Joseph provide a detailed overview of thevarious language impairments observed in some people withautism. Tony Charman, in “Why is joint attention a pivotalskill in autism”, makes the case that a fundamental flaw in achild’s ability to engage in joint attention may be the precursorfor future social and language impairments.

Much of the recent information on the relations betweenbrain and cognition in autism arise from the use of innovative

technologies. Klin and colleagues describe a series of studieswith eye tracking and functional MRI that addresses theparadox that individuals with autism are able to solve explicitsocial tasks but are very impaired in their ability to deal withnaturalistic social contingencies. This topic is taken up againin the last chapter of the book by Bob Schultz and colleagues,“The role of the fusiform face area in social cognition:implications for the pathobiology of autism”.

For those intrigued by the history of autism, the chapterby Hippler and Klicpera is a gem. They review HansAsperger’s original notes and medical records to determinewhether current diagnostic criteria for Asperger’s syndromereflect the original description of what he called “autisticpsychopathy”. The chapter has implications for currentdebates on the existence and characteristics of Asperger’ssyndrome.

Although this book does an excellent job of dealing withmuch of the cognitive side of autism, there are areas ofresearch that are not covered. There is very little about theneuropathology of autism and the increasing evidence thatthe brains of individuals with autism have an abnormallyrapid course of development. Molecular aspects of autism alsoreceive modest attention. However, the growth and breadth ofautism research would be near impossible to cover in a singlemonograph. This is an extremely valuable book for clinicians,educators, and basic scientists alike who are interested in thebehavioral phenomenology of autism.David G Amaral

Practical Guide to EpilepsyMark ManfordButterworth Heinemann, 2003£32·99, 335 ppISBN 0 7506 4621 7

In both clinical neuroscience and basicresearch there is much interest in epilepsy.

Despite many established and lengthy textbooks on epilepsy,it is often a daunting task for the junior clinician to find theirway through the numerous clinical variants and especiallythe treatment strategies. This book is handy, focusing onpractical clinical issues to provide an introduction toepilepsy. It aims to give the reader some indicators fordiagnosis and treatment. The extensive use of algorithmsand charts provide helpful overviews of pathways for clinicaldecisions, giving indicators for diagnosis and treatment.

The first section of the book consists of introductorychapters on pathophysiology, anatomy, genetics, and theepidemiology of epilepsy. The information presented iscomprehensive, but also limited by its aims of fostering anunderstanding of treatment issues and outcomes. The majorsteps of diagnosis are then covered in the second section. Athorough discussion of differentials and an outline of focalepilepsy syndromes are given, followed by introductions toEEG and neuroimaging. Additional chapters covertreatment in special patient groups, such as children, theelderly, women, and women during pregnancy. Furtherstrengths of the book are dedicated chapters on acute

symptomatic seizures and status epilepticus, which providevaluable discussion of clinically important situations. Thereis also a chapter on surgery for people with epilepsy (albeitunfortunately placed in the special situations section) givinga useful outline of an increasingly important but underusedtherapeutic option. Finally, there are small chapters dealingwith cognitive, psychiatric, and social aspects of epilepsy,which fall somewhat short of giving thorough guidance.

Overall, Practical Guide to Epilepsy is a well-balancedcomprehensive guide to the clinical management of epilepsy.The practical approach towards diagnosis and treatment is astrength of this book. The author succeeds in providing aclear account of the complex problems involved. Casereports used throughout the book make important pointsclear. The references included at the end of each chapter forfurther reading often cite seminal studies on a particulartopic. One might argue that more attention should havebeen given to technical aspects such as neuroimaging andthat more recent references should have been included, butultimately this book delivers an excellent clinicalintroduction. Clinicians in any clinical neurosciencespeciality will find it a useful guide.Igor NenadicThis book is published by Elsevier of which The Lancet Neurology is part

Erratum

Elske Hoitsma, Carin G Faber, Marjolein Drent, and Om P Sharma.Neurosarcoidosis: a clinical dilemma. Lancet Neurol 2004; 3: 397–407. In case report2 of this review, “26 blood cells per min3” should read “26 blood cells per cm3”.