Brainstorm

June 4, 2018
In an informative if less than riveting casebook, neurologist O’Sullivan (Is It All in Your Head?) draws on clinical experiences with patients suffering from epilepsy to examine the mysterious connections between memory, imagination, fear, and seizure. She dubs epilepsy “the ultimate disease chameleon” and in 12 case studies tries to shed light on the much misunderstood affliction. Though the storytelling is disappointingly pedestrian, the author succeeds both in showing the brain as the most sophisticated of all puzzles and in giving a sense of the intricate problem solving that goes into the diagnosis and treatment of brain ailments. She is candid about her uncertainties—the risks of surgery, the side effects of medications, the limitations of technology. Movingly, she recounts her struggle to understand a medical puzzle—a healthy-looking patient with an abnormal brain scan—and her sense of helplessness when another patient has a seizure during a clinic visit. However, the frequent asides on the history of brain research tend to impede the stories’ flow, and the excitement of “detective stories” promised by the subtitle never arrives. However, the various viewpoints included from patients coping with epilepsy will make this a valuable resource for anyone interested in the topic.

August 1, 2018
A collection of probing and empathetic stories of difficult neurological cases.Epilepsy is one of the oldest of human diseases. Suddenly, the brain's neurons fire at once, producing the massive electric discharge of a general seizure--or if only a subset of neurons fires, it's a focal seizure. British epilepsy consultant O'Sullivan (Is It All in Your Head?: True Stories of Imaginary Illness, 2017), a winner of the Wellcome Book Prize, writes compassionately and sensitively about mostly those who suffer from focal seizures. There's Mike, a high-powered lawyer who developed epilepsy following a presumed mugging that injured his frontal lobes; Eleanor, a young woman whose most basic movements could trigger seizures, causing a complete loss of muscle tone (she grew afraid to leave her bed); and Donal, a school janitor facing job loss who developed seizures in which he saw cartoon figures of the seven dwarfs moving across the room. Most of O'Sullivan's patients spent days in a telemetry clinic with electrodes attached to their scalps and under surveillance in hopes of capturing when and where a seizure would occur. While these studies have been invaluable in aiding diagnosis, they also reveal how much of the brain and its interconnectedness remains unknown. "There are still gaping holes in our knowledge about the brain," writes the author. "Even the basic questions remain unanswered." O'Sullivan also writes about how much she has learned from her patients. Many are not much helped by drugs, and the locations of their seizures are often too risky for surgery. Yet they show resilience and a determination to get on with their lives in spite of epilepsy.O'Sullivan is a skilled storyteller in the same league as Oliver Sacks. Furthermore, she includes asides on the history of neurology, which, perhaps more than other specialties, owes much to the patients who have endured injury, strokes, degenerative diseases, and epilepsy in order for researchers to better understand how the brain is organized.

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