BOOK REVIEWS

Restless Legs Syndrome

K. Ray Chaudhuri, P. Odin and C. W.

Olanow, eds. Taylor & Francis, London,

New York, 2004, 147 pp., hardcover,

$99.95, ISBN 1842141627

Restless legs syndrome (RLS) is the com-

monest movement disorder, affecting as

many as 10% of the general population

and, recently, is easily treatable with con-

ventional drugs. However, as many other

movement disorders, it remains under-

diagnosed and under-recognized by the

medical community and, thus, has earned

the unfortunate title of being the �com-

monest movement disorder you have

never heard of�. This latter sentence until

recently has often been used by many

physicians and patients, although during

the last years many papers and treatment

reports have been published. RLS can be

seen in association with many different

conditions, and patients frequently pre-

sent to neurologists, gerontologists, and

rheumatologists, but the bulk of cases are

still seen by general practitioners, and it is

important that all of them should be

familiar with the condition which, by it-

self, is not life-threatening but can mani-

fest as serious pain disorder frequently

leading to depression. The present text –

the first book specifically dedicated to

RLS – edited by experts from the UK,

Germany, and USA, is written by an

international panel of clinicians from

Germany, Spain, the USA, and the UK.

It presents the various facts of the

fascinating condition and tries to shed

light on the causes, epidemiology, differ-

ential diagnosis, and treatment of RLS in

10 chapters. After a short introductory

article on �What is RLS� and its history,

the diagnostic criteria for idiopathic and

probable RLS in adults and children are

outlined with practical questions to ask

the RLS sufferer (P. Odin). The chapter

on epidemiology emphasizes that RLS is a

common disorder, with a prevalence from

5 to 15% in the Caucasian population and

an onset before the age of 20 years in up

to 43% of adults. Based on current

estimates, there may be 8–10 million suf-

ferers in the UK alone. RLS may be

associated with iron deficiency, anemia,

renal failure/uremia, pregnancy and,

possibly, Parkinson disease (PD). During

pregnancy, RLS has been reported in 11–

27% of women, usually during the third

trimester. The pathophysiology of RLS

seems to be related with disturbances of

the central dopaminergic system, iron

metabolism, and opioid neurotransmis-

sion, but its definite basis remains to be

elucidated. Chapter 5 deals with clinical

features, differential diagnosis of RLS and

its relationship with PD, as PD patients

may complain of similar symptoms

because of difficulties in sleeping. Secon-

dary RLS occurs in neuropathies, mye-

lenopathies, uremia, iron deficiency,

pregnancy, PD, tremor, ataxia, rheuma-

tologic, and other conditions or may be

exacerbated by medication, e.g. mirtaze-

pane, serotonin, or antihistamines.

Differential diagnosis and treatment of

RLS are overviewed by C.W. Olanow and

et al. who present drugs and non-medical

management in tabulated form and pro-

pose exact guidelines for treatment of

RLS. After a brief comment on augmen-

tation and rebound (Chaudhuri), an

extensive review is given on diagnosis of

the RLS using the sleep laboratory

(Garcia-Borreguero et al.), dealing

with polysomnography (sleep studies)

and relevant methods, suggested

immobilization test, and actigraphy, the

latter providing information over longer

periods. The summary and conclusions

(Chaudhuri) are amended by a list of

contact points all over the world. All

chapters are well written, with infor-

mative subheadings, many tables and

illustrations, summaries, and extensive

reference lists ending 2004. As in many

multi-author books, there is considerable

overlap of the individual articles.

However, the book is an important

resource material for specialists across a

range of disciplines, most notably

neurology, psychiatry, sleep medicine,

geriatrics, rheumatology, internists, and

general practitioners. It will also be

useful for other health care specialists as

an aid to early recognition, exact differ-

ential diagnosis, and proper management

of this distressing condition. The exact

pathogenesis and pathophysiology remain

to be further elucidated.

K. A. Jellinger

Vienna, Austria

Neurological Rehabilitation

of StrokeNick Losseff, ed. Taylor & Francis,

London, 2004, 100 pp., hardcover,

£UK29.55, ISBN 1841843229

The present book is the second in the

Queen Square Neurological Rehabilitation

Series (series editor A.J. Thompson, Lon-

don), a series of concise reference works

focussing on the essentials of neurological

rehabilitation to aid patient management.

Edited by Nick Losseff, consultant neuro-

logist to several prestigious London insti-

tutions, a panel of London rehabilitation

specialists in six chapters present a timely

overview of the major problems in neuro-

logical rehabilitation of stroke addressed

to all professionals engaged in the care of

patients with stroke. After a review of the

potential for recovery and repair following

stroke based on experimental and human

work emphasizing that rehabilitative

training appears to be a vital component

needed to facilitate brain plasticity, an

interdisciplinary approach to acute stroke

rehabilitation is presented (inter-

disciplinary teamwork covering physio-

therapy, occupational, speech and

language therapy, clinical neuro-

physiology, nutrition and dietetic service,

prevention of secondary complications

and ongoing rehabilitation with a case

illustration). Follow a medical view of the

impact of the disease concerning outcome

after stroke, evolution of impact, and re-

source implications and a short personal

view on the same subject, while the next

chapter reviews evaluation of the outcome

of rehabilitation interventions emphasi-

zing the assessment of stroke outcomes,

disability and handicap after stroke,

cost-effectiveness of stroke care, and evi-

dence for stroke rehabilitation interven-

tions covering several fields of function

and dysfunction. Finally service delivery

and models of care are presented with

impact on acute stroke and rehabilitation

units and their cost-effectiveness.

All chapters are clearly written, based

on personal experience of the authors, and

give an excellent overview of the basics,

principles, effectiveness of stroke rehabil-

itation that needs special units and inter-

disciplinary efforts to promote patients�management after severe cerebrovascular

disorders and handicaps. The book is well

worth reading for all who are interested

and engaged in the care and rehabilitation

of stroke patients.

K. A. Jellinger

Vienna, Austria

Imitators of Epilepsy

Peter W. Kaplan and Rober S. Fisher, eds,

2nd edn Demos Medical Publishing, New

York, 2004, 296 pp., hardcover, ISBN

1-888799-83-8

Many patients referred for an epilepsy

manifestation, in fact, suffer from other

conditions imitating a seizure disorder.

These conditions are a diverse group that

invoice consideration of many areas of

clinical medicine. The most important

490 � 2005 EFNS

European Journal of Neurology 2005, 12: 490–492