Since the last edition of this book there have been tremendous strides in the fi eld of pediatric epileptology.
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New experimental models now closely mimic some uniquely pediatric conditions, and these are producing startling information about epileptogenesis in the young. Owing to advances in biochemistry and next generation sequencing, we know more about the specifi c causes of early life epilepsies associated with encephalopathy than ever before. Technological improvements in imaging have allowed us to see subtle pathologic changes like small regions of cortical dysplasia that were previously only evident on gross pathological specimens. The advances in genetics and imaging are bringing clarity to our classifi cation schemes, and allowing us to group epilepsies in more clinically meaningful ways. Autoimmune disorders have surfaced as very important causes of some catastrophic presentations. There are new medications with novel mechanisms of action, clever refi nements of dietary treatments, and bold new surgical approaches. There have been additional studies examining the long-term outcome of various conditions and we have a much better appreciation of comorbid conditions. All of these come together to make it one of the most exciting epochs in pediatric epilepsy and we believe these areas are already having an impact on the quality of lives of our patients
How does the busy clinician or student keep up with it all? This question has been fi rst and foremost on the editors’ minds. Closely following the tenor of the previous editions, this book is designed to address the needs of our colleagues by providing them with the latest information presented in a manner that is clinically relevant. What follows in a highly practical but sophisticated guide to the care of children with pediatric epilepsy and it is our highest hope that it brings these new scientifi c discoveries into daily relevance.
This fourth edition follows the basic format of the preceding volume with some important changes and additions. There is a new discussion of specifi c conditions related to epilepsy including tuberous sclerosis. The book now includes a discussion of those issues of particular relevance to the female patient beyond just teratogenesis, including polycystic ovary syndrome and catamenial epilepsy. There is a comprehensive review of the latest advances in the treatment of status epilepticus, along with an expanded discussion of the epilepsy spectrum, illustrating that epilepsy is more than just a susceptibility to seizures. Chapters that were also in the previous edition have all been updated substantially, with nearly a decade’s worth of new data, analysis, and conclusions
Part III of this book, Age-Related Syndromes, groups the epilepsies in a novel way; looking at epilepsies from the perspective of an electroencephalographer. However, the groupings will be very familiar to the reader. There are the familial (or autosomal dominant) epilepsies with focal seizures, the genetic generalized epilepsies, the self-limited epilepsies (previously called idiopathic epilepsies with focal seizures), the epilepsies with encephalopathy, and the epilepsies related to focal structural lesions. Even if a specifi c syndrome cannot be identifi ed in a given patient, the general grouping can often be determined based upon the history and physical exam and a sample of interictal EEG
Some words about the title of the book from the editors. The publisher and the editors came together to suggest it be renamed Pellock’s Pediatric Epilepsy. This was not simply a courtesy to our good friend and mentor, but it more accurately refl ects what is unique and valuable about this text. Those who have been fortunate enough to have been taught by Dr. Pellock, in one form or another, immediately understand what we are talking about. Jack had an uncanny ability to present up-to-date and sophisticated information in a straightforward, relaxed, and practical manner that was easily understood. It was a gift, and coupled with his unequaled energy and enthusiasm for teaching it had an immediate infectious quality. Time and again we saw how the entire faculty of symposium or course became energized and engaged by his presence.
We hope to capture some of his spirit within the pages of this text. We would like to thank Professor Blaise Bourgeois for his critical contributions to the previous editions, including his organization of the medications in our prior edition. Ms. Gladys (Cricket) McCafferty, Beth Barry, and Norman Graubart have tirelessly and consistently propelled the book forward. Without their help, this would not have been a success.
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