An Essential Text for Your Neurology Bookshelf
An Essential Text for Your Neurology Bookshelf
Editor's Note:
As the fourth edition of Herbert Jasper'sBasic Mechanisms of the Epilepsiesis published, Michael Rogawski, MD, PhD, Chairman, Department of Neurology, University of California, Davis, -- an editor of this edition -- and Dr. Andrew Wilner, MD discuss the evolution of the original textbook and the process of continuing and improving on Jasper's legacy.
Dr. Wilner: Dr. Rogawski, you are one of the editors of the fourth edition of Jasper's Basic Mechanisms of the Epilepsies. Why is this book important, and who should read it?
Dr. Rogawski: First, let me give you a bit of background. This is the fourth edition of a book that some consider to be the bible of basic epilepsy research.
The first edition was published in 1969. The story of the book begins with the appointment of H. Houston Merritt by the Surgeon General to chair an advisory committee on epilepsy. Merritt formed a subcommittee on research and training that was led by Arthur A. Ward, Jr, an epilepsy neurosurgeon at the University of Washington in Seattle. Dr. Ward established a basic research task force headed by Herbert H. Jasper of the Montreal Neurological Institute and Hospital (MNI). The task force got together and concluded that basic epilepsy research needed stimulation, and Dr. Jasper decided to hold a workshop and symposium. From that, they published a comprehensive monograph that was the first edition of Basic Mechanisms of the Epilepsies.
Dr. Jasper was a distinguished epilepsy researcher. He had a PhD in psychology and a Doctor of Science degree from the University of Paris, and for 3 decades he worked with the great neurosurgeon Wilder Penfield at the MNI. He studied many aspects of epilepsy but is perhaps best known for his studies on thalamocortical mechanisms in absence epilepsy.
Dr. Wilner: Dr. Jasper was still alive when I was a resident and fellow at the MNI. He has an incredible legacy.
Dr. Rogawski: Yes. I met him many times during my travels to Montreal. He was a delightful person who was full of wit. Even when he was very advanced in age, he enjoyed speaking with students about their research and playfully chiding us all for failing to keep up with the younger generation of scientists.
Since that original edition of Dr. Jasper's book, similar workshops and symposiums have been held at roughly 14-year intervals. Each time, a new edition of the Basic Mechanisms of the Epilepsies was published. In 1999, the third edition of the book was named in honor of Dr. Jasper, and we followed this tradition in the fourth edition.
The most recent series of workshops was held for 4 days in March of 2009 at Yosemite National Park. These workshops consisted of presentations on a broad range of topics in basic epilepsy research. Then after the meeting, the 5 editors of the book got together for a planning session. We met in a room in the hotel with the spectacular majestic pines and glaciated peaks of Yosemite National Park visible just outside our window. It was awe-inspiring. We put together the outline for the book during this meeting.
Then, we met again in August 2009 in no less spectacular surroundings in Malibu, California. We took a walk to clear our minds on cliffs overlooking the Pacific Ocean. This was also magnificent.
At that point, we began the serious work of recruiting authors to write the various chapters of the book. We were assisted by 7 eminently able and distinguished basic epilepsy researchers from the United States, Italy, and Germany. These 7 associate editors helped us review the 90 chapters we recruited. We have exactly 200 authors for these 90 chapters.
The book itself is 1199 pages long and consists of 5 sections. As is traditional, the first chapter assesses the progress that has been made in the last decade of basic epilepsy research and prioritizes where efforts in research should be accelerated and enhanced. Although the book is comprehensive and includes virtually every area of contemporary basic epilepsy research, one of the primary focuses is on epilepsy genetics. It foresees the promise of personalized medicine based on genomic information. The book also places an emphasis on taking the discoveries of basic epilepsy research and disease mechanisms and translating them into molecular and cellular therapeutic strategies that we hope will bring repairs and cures to specific epilepsies.
Dr. Wilner: So although the book is very much research-based, clinicians may find it interesting -- particularly the introduction and the therapeutics sections, and also to catch up on new findings in genetics.
Dr. Rogawski: Correct. We believe clinicians will find the book useful. As you point out, the book contains a large amount of information about epilepsy genetics. In addition, this edition for the first time has a section on epilepsy therapeutics. This fifth section of the book covers the new molecular targets for antiepileptic drugs that were discovered because of studies of some of the recently introduced antiepileptic medications. We discuss such targets as alpha2delta (calcium channel subunit); SV2A (synaptic vesicle protein 2A), and newer approaches to therapy, such as neurosteroids.
We also have included a chapter on an old therapeutic approach, the ketogenic diet. This chapter provides an overview of the explosion of research on the ketogenic diet in the past few years. The therapeutics section also considers research on drug resistance in epilepsy.
The last several chapters concern forefront approaches, including stem cell therapy and gene therapy, that we do not anticipate will be available to patients in the near future but give a flavor of the diversity of treatment approaches that are being studied in laboratories throughout the world. The book starts with the basic mechanisms of excitability and genetics and ends with a consideration of how these discoveries can be applied in the treatment and cure of epilepsy.
Dr. Wilner: The large section on epilepsy therapeutics represents a dramatic departure from the traditional neurology textbooks that included a lot of descriptive information and pathophysiology, and a treatment section that usually totaled 1 or 2 paragraphs. I think this is evidence of a major change in neurology and specifically in epilepsy, where we have more to offer and explore in the domain of therapeutics.
Dr. Rogawski: We thought that the state of the art had advanced to a point where our understanding of basic epilepsy mechanisms was sufficiently detailed that we could begin to think about how to translate this information into therapeutic approaches. The editors embraced the concept of including a major section on therapeutic strategies of various kinds, which is a significant departure from the previous editions.
Dr. Wilner: Before we conclude, we should mention that the book is available free of charge at the National Institutes of Health (NIH) Website.
Dr. Rogawski: Correct. The book is published as a hardcover text as part of Oxford University Press' Contemporary Neurology Series. In addition, the chapters are available on the NCBI (National Center for Biotechnology Information) Bookshelf, which is the electronic book publishing platform of the National Library of Medicine at NIH. Anyone who is interested will be able to access the chapters on the Bookshelf Website. The chapters will be indexed in PubMed, and you will be able to click through to the Bookshelf when a chapter comes up in a PubMed search.
Dr. Wilner: The editors and 200 authors clearly worked hard to make this book a reality.
Dr. Rogawski: It was gratifying to be involved with this project because it provides a comprehensive overview of the accomplishments of a very large number of researchers in the field of epilepsy over the past decade. To be able to see that come together in one place is stunning and is a testament to the vitality of the field and the energy and commitment of basic researchers in the field of epileptology.
Dr. Wilner: Dr. Rogawski, I want to thank you for your hard work as a coeditor of Jasper'sBasic Mechanisms of the Epilepsies and for speaking with Medscape about this very instructive new book.
Dr. Rogawski: Thank you for the opportunity. It has been a pleasure to speak with you.
Editor's Note:
As the fourth edition of Herbert Jasper'sBasic Mechanisms of the Epilepsiesis published, Michael Rogawski, MD, PhD, Chairman, Department of Neurology, University of California, Davis, -- an editor of this edition -- and Dr. Andrew Wilner, MD discuss the evolution of the original textbook and the process of continuing and improving on Jasper's legacy.
Dr. Wilner: Dr. Rogawski, you are one of the editors of the fourth edition of Jasper's Basic Mechanisms of the Epilepsies. Why is this book important, and who should read it?
Dr. Rogawski: First, let me give you a bit of background. This is the fourth edition of a book that some consider to be the bible of basic epilepsy research.
The first edition was published in 1969. The story of the book begins with the appointment of H. Houston Merritt by the Surgeon General to chair an advisory committee on epilepsy. Merritt formed a subcommittee on research and training that was led by Arthur A. Ward, Jr, an epilepsy neurosurgeon at the University of Washington in Seattle. Dr. Ward established a basic research task force headed by Herbert H. Jasper of the Montreal Neurological Institute and Hospital (MNI). The task force got together and concluded that basic epilepsy research needed stimulation, and Dr. Jasper decided to hold a workshop and symposium. From that, they published a comprehensive monograph that was the first edition of Basic Mechanisms of the Epilepsies.
Dr. Jasper was a distinguished epilepsy researcher. He had a PhD in psychology and a Doctor of Science degree from the University of Paris, and for 3 decades he worked with the great neurosurgeon Wilder Penfield at the MNI. He studied many aspects of epilepsy but is perhaps best known for his studies on thalamocortical mechanisms in absence epilepsy.
Dr. Wilner: Dr. Jasper was still alive when I was a resident and fellow at the MNI. He has an incredible legacy.
Dr. Rogawski: Yes. I met him many times during my travels to Montreal. He was a delightful person who was full of wit. Even when he was very advanced in age, he enjoyed speaking with students about their research and playfully chiding us all for failing to keep up with the younger generation of scientists.
Since that original edition of Dr. Jasper's book, similar workshops and symposiums have been held at roughly 14-year intervals. Each time, a new edition of the Basic Mechanisms of the Epilepsies was published. In 1999, the third edition of the book was named in honor of Dr. Jasper, and we followed this tradition in the fourth edition.
The most recent series of workshops was held for 4 days in March of 2009 at Yosemite National Park. These workshops consisted of presentations on a broad range of topics in basic epilepsy research. Then after the meeting, the 5 editors of the book got together for a planning session. We met in a room in the hotel with the spectacular majestic pines and glaciated peaks of Yosemite National Park visible just outside our window. It was awe-inspiring. We put together the outline for the book during this meeting.
Then, we met again in August 2009 in no less spectacular surroundings in Malibu, California. We took a walk to clear our minds on cliffs overlooking the Pacific Ocean. This was also magnificent.
At that point, we began the serious work of recruiting authors to write the various chapters of the book. We were assisted by 7 eminently able and distinguished basic epilepsy researchers from the United States, Italy, and Germany. These 7 associate editors helped us review the 90 chapters we recruited. We have exactly 200 authors for these 90 chapters.
The book itself is 1199 pages long and consists of 5 sections. As is traditional, the first chapter assesses the progress that has been made in the last decade of basic epilepsy research and prioritizes where efforts in research should be accelerated and enhanced. Although the book is comprehensive and includes virtually every area of contemporary basic epilepsy research, one of the primary focuses is on epilepsy genetics. It foresees the promise of personalized medicine based on genomic information. The book also places an emphasis on taking the discoveries of basic epilepsy research and disease mechanisms and translating them into molecular and cellular therapeutic strategies that we hope will bring repairs and cures to specific epilepsies.
Dr. Wilner: So although the book is very much research-based, clinicians may find it interesting -- particularly the introduction and the therapeutics sections, and also to catch up on new findings in genetics.
Dr. Rogawski: Correct. We believe clinicians will find the book useful. As you point out, the book contains a large amount of information about epilepsy genetics. In addition, this edition for the first time has a section on epilepsy therapeutics. This fifth section of the book covers the new molecular targets for antiepileptic drugs that were discovered because of studies of some of the recently introduced antiepileptic medications. We discuss such targets as alpha2delta (calcium channel subunit); SV2A (synaptic vesicle protein 2A), and newer approaches to therapy, such as neurosteroids.
We also have included a chapter on an old therapeutic approach, the ketogenic diet. This chapter provides an overview of the explosion of research on the ketogenic diet in the past few years. The therapeutics section also considers research on drug resistance in epilepsy.
The last several chapters concern forefront approaches, including stem cell therapy and gene therapy, that we do not anticipate will be available to patients in the near future but give a flavor of the diversity of treatment approaches that are being studied in laboratories throughout the world. The book starts with the basic mechanisms of excitability and genetics and ends with a consideration of how these discoveries can be applied in the treatment and cure of epilepsy.
Dr. Wilner: The large section on epilepsy therapeutics represents a dramatic departure from the traditional neurology textbooks that included a lot of descriptive information and pathophysiology, and a treatment section that usually totaled 1 or 2 paragraphs. I think this is evidence of a major change in neurology and specifically in epilepsy, where we have more to offer and explore in the domain of therapeutics.
Dr. Rogawski: We thought that the state of the art had advanced to a point where our understanding of basic epilepsy mechanisms was sufficiently detailed that we could begin to think about how to translate this information into therapeutic approaches. The editors embraced the concept of including a major section on therapeutic strategies of various kinds, which is a significant departure from the previous editions.
Dr. Wilner: Before we conclude, we should mention that the book is available free of charge at the National Institutes of Health (NIH) Website.
Dr. Rogawski: Correct. The book is published as a hardcover text as part of Oxford University Press' Contemporary Neurology Series. In addition, the chapters are available on the NCBI (National Center for Biotechnology Information) Bookshelf, which is the electronic book publishing platform of the National Library of Medicine at NIH. Anyone who is interested will be able to access the chapters on the Bookshelf Website. The chapters will be indexed in PubMed, and you will be able to click through to the Bookshelf when a chapter comes up in a PubMed search.
Dr. Wilner: The editors and 200 authors clearly worked hard to make this book a reality.
Dr. Rogawski: It was gratifying to be involved with this project because it provides a comprehensive overview of the accomplishments of a very large number of researchers in the field of epilepsy over the past decade. To be able to see that come together in one place is stunning and is a testament to the vitality of the field and the energy and commitment of basic researchers in the field of epileptology.
Dr. Wilner: Dr. Rogawski, I want to thank you for your hard work as a coeditor of Jasper'sBasic Mechanisms of the Epilepsies and for speaking with Medscape about this very instructive new book.
Dr. Rogawski: Thank you for the opportunity. It has been a pleasure to speak with you.
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