The biggest difference is what the book does with Tangina Barrons, the little psychic lady. She's introduced into the story far earlier than in the movie. We got a whole background on her, and how she knows Dr. Lesh. Tangina sees her gift as a curse, and she's hoping Dr. Lesh can cure her somehow with sleep therapies and study. We learn that Tangina can astral project her soul into the spirit realm. It's during one of these trips that Tangina discovers Carol Anne trapped in the spirit world, so she knew what was happening before even meeting the Freeling's in this version of the story. Dr. Lesh and Tangina seek out the Freelings in order to help, as opposed to the movie, where Steven Freeling goes to the university to get their help.
The character of "The Beast", the mysterious, sinister entity who mastermined Carol Anne's kidnapping, is explored some more. Tangina has psychic battles with it, in the spirit realm, and is able to gleam some insights into it.
“Twice, now,” Tangina continued, “in my journeys to the dream lands, I have encountered this great evil near the child. It is not the lord of this dimension, but it holds great sway, all the same. Great power. This morning I saw it—almost clearly. It was chasing the little girl. It manifested itself to me in different forms, so that in my weakened condition I would lose my way from fear. We escaped, this time, the child and I. But the Beast remains strong. He exerts great will over all the pitiable beings of that universe. He is a thing of horror.”
“It is protean, this Beast. Once, I think, it was human—now, it loves its twisted existence. It would neither come back nor go on, if it could. It is obsessed with its wicked self. I have seen it before, in other forms. And now I have seen it again.”
We even learn from Tangina the Beast's actual name: gHalâ, gHalâ. This was, of course, before the sequel and the Reverand Kane stuff. It also expands some more on something that was kinda hinted at in one scene of the movie: The Beast is a sex pervert. It fondles Diane Freeling while asleep, and would have done more, if not called upon to do battle with Tangina.
The book expands on the character of the ghostly woman from the movie who descends the staircase, with an entrouage of spirit orbs. She is called "The Waiting Woman". She waits eternally in that realm of lost souls for some unknown suitor. She's neither happy nor sad about it, it's just what she does, eternally patient. The other ghosts like to be near her, as her eternal patience sooths their own longing somehow. She tries to protect the other spirits, saying that she lets the Beast "use" her, from time to time, in exchange for leaving the others alone. More sex pervert stuff, I guess. When the other spirits are going into the light, and escaping the Beast, she decides to stay behind and continue her waiting. Tangina isn't sure if she's actually a ghost, or some sort of entity.
The book also greatly expands on the idea of alternate dimensions. We learn there are other realms besides ours, and the realm of lost souls. Other doorways in and out. We meet some of the strange creatues from these other planes
There's a creature of smoke and haze named Sceädu, who inhabits it's own dimension. This creature itself is the doorway into the realm of lost souls, and Tangina must pass through him to enter, and must pass through him again to exit, as he follows you in. In his own world, he behaves in an ominous way, but in the lost souls realm, he's playful and evasive.
There's a creature named Fantabel, a being made of flame, who can also enter into that realm. This creature also seems playful and mischevious. It likes to fly Carol Anne high into the air, and drop her. Carol Anne doesn't mind, as she feels no pain in that realm. Fantabel and Sceädu chase eachother around and do strange dances when together.
There's also a creature that resembles a gnarled old tree. It has no name that Tangina can discern. This creature seems to be a butt monkey of sorts, as Fantabel likes to set it on fire every time it's around.
These 3 creatures later show up in the Freeling's living room, where they do their schtick, before departing again. Tangina is alarmed when she hears about it. Coming over into our plane is a big no-no, as it's dangerous for them and us. She's thinks this bold and impudent act was instigated by The Beast somehow.