A neurological study of newborn infants

A neurological study of newborn infants

600 BOOK REVIEWS quate. They, as well as practising physicians and neurologists, need a relatively short volume in which the principles of human gen...

177KB Sizes 1 Downloads 75 Views

600

BOOK REVIEWS

quate. They, as well as practising physicians and neurologists, need a relatively short volume in which the principles of human genetics are clearly laid out in a form comprehensible to those with little fundamental knowledge of the subject and of the higher mathematics which all too often confuses the non-expert reader of some of the more definitive texts. Professor Emery has fulfilled this very real need. In just over 230 pages he has written an eminently clear, logically constructed and readable commentary upon the subject which can be heartily recommended. Beginning with a historical introduction, he goes on to review the chemical basis of inheritance, chromosomes and chromosomal abnormalities in developmental genetics. These introductory chapters are followed by sections on inheritance

in families, genetic factors in some common diseases, pharmaco-genetics, population genetics and natural selection, and a shorter section on radiation and human heredity. In his final chapter on genetics and the physician he gives a valuable, though necessarily brief, survey of those aspects of human genetics which are of current practical value to the practising doctor. Each chapter is concluded with a carefully selected list of leading references to the literature and at the end of the volume there is a glossary of terms in common use, together with a short general bibliography which represents a valuable guide to further reading. This volume can be confidently recommended and will undoubtedly achieve the success it so clearly deserves. JOHN N. WALTON

Spezielle neurologische Untersuchungsmethoden,

full. The section on neuroradiology covers straight X-ray of the skull and spine and the various methods of contrast radiography and is notable for its magnificent photographs. The section on myography includes not only a full account of the electromyogram and estimation of peripheral nerve conduction velocities, but also an interesting account of the use of combined mechano- and electro-myography in the study of the reflexes in spinal cord disease. The basic principles of electroencephalography are well described, again with excellent illustrations. The book concludes with sections on echo-encephalography and radioactive cerebral scanning. This excellently produced book, while it is understandably not cheap, will be most useful to junior staff in medical and surgical neurological units, but the clarity of the writing and of the illustrations recommend its inclusion in any neurological library. J. B. STANTON

by G. SCHALTENBRAND, viii+ 193 pages, 179 illustrations, Georg Thieme Verlag, Stuttgart, 1968, D M 58.--. Special methods of investigation in neurology have become more and more refined and consequently more valuable in diagnosis, so that now they almost constitute sub-specialities of the subject and no one individual can be an expert in all the fields. This book is particularly welcome therefore, since it provides in one volume definitive accounts of techniques and interpretation in analysis of the cerebrospinal fluid, neuroradiology, myography, electroencephalography, echo-encephalography, and radioactive isotope scanning, all written by experts. The section on the cerebrospinal fluid describes in detail the techniques for obtaining the fluid and for the estimation of the various components, solid and biochemical, of the fluid. Variations in these constituents in disease are discussed in

A Neurological Study of Newborn Infants, by DAVID J. BEINTEMA, 178 pages, Spastics International Medical Publications and William Heinemann Medical Books Limited, London, 1968, 37s.6d; $4.80. Sir Francis Walshe is said to have described the field of muscle disease as a wasteland. By contrast the neurology of the newborn might be called a jungle; a largely uncharted area complicated by the rapid but variable development which occurs in the first few days of life; entangled by the widely different responses which may be obtained from a baby in different states of wakefulness, hunger or contentment and made perilous by the severity and suddenness of the dis-

orders which may befall the newborn infant. This book, the author's doctorate thesis, is one of a number of painstaking neurological studies of infants which have come from the department of Dr. Heinz Prechtl at the University of Groningen. Its aim is to answer three questions, "(1) What standardisation procedures should the examiner introduce in order to get reliable information from the neurological examination? (2) What is the developmental course of neurological signs during the first days of life? (3) Do obstetrical and postnatal conditions affect the developmental course and consistency of neurological signs throughout the neonatal period?" The data were collected by repeated examina-

J. neurol. Sci (1969) 8:598-606

nOOK REVmWS

601

tion of 49 full term infants during the first 9 days of life. Information on up to 28 different signs was recorded in 364 separate examinations. These signs were correlated with each other and with information on the mother's pregnancy and labour and on the infant's state at birth as observed by the author himself. The pattern of the examination was standardised strictly and the state of wakefulness and activity of the infant during examination was carefully defined and controlled. The definition of these methods is a useful contribution in itself but the most valuable part of the work is the long section on the individual physical signs, their development and consistency and their cross-correlations. The infants are divided into three groups - - those who had signs of foetal distress during labour, those whose mothers had obstetrical complications during pregnancy, and a low risk group whose gestation and birth had been normal. The neurological development of the three groups was compared. At first sight it is a little disappointing that no very new general conclusions have been drawn from the results. The author confirms that it is possible to allocate many of the neurological abnormalities found in infancy into one of three

syndromes previously described by Dr. Prechtl; the "apathy syndrome", the "hyperexcitability syndrome" and a pattern of asymmetry of response unfortunatelynamedthe "hemisyndrome". The prognostic significance of these syndromes is still uncertain. It appears that the results of examination in the first 2 or 3 days of life, even when care is taken to standardise the techniques, are influenced by too many factors to be of much value in detecting minor abnormalities, but that after this the results are more consistent. The conclusions about the effect of obstetrical and postnatal conditions on the neurological signs are indefinite and are perhaps the least satisfying part of the work. This is inevitable with such a limited number of cases and in the absence of follow-up information. However, by establishing facts about methods of examination and the findings which may be expected the author has prepared the ground for further studies. Both he and others who make careful use of his book will now be able to examine large numbers of infants efficiently and reliably. Perhaps before long we shall begin to have some really trustworthy information about the effect of events in pregnancy and parturition upon the developing nervous system. DAVID GARDNER-MEDWIN

A Stereotaxic Atlas of the Java Monkey Brain (Macaca irus), by T. R. SHANTHA,S. L. MANOCHA

The present atlas, which appears to be the first for the Java monkey, contains a series of coronal brain sections spaced at 1 m m intervals and extending between 18.5 m m anterior, and 8.0 m m posterior, to the external auditory meati. At each coronal level there are 2 photomicrographs, one of cells (Nissl stain) and one of fibres (Weft method). The photographs, printed on glossy paper, show their details clearly and magnify the original brain sections 9.5 times. The brain structures have been identified according to the Nomina Anatomica; the authors have wisely not attempted to outline the probable boundaries of the various nuclei and tracts. Brain atlases are notoriously expensive and for this reason the present one offers excellent value for its cost; it can be recommended without hesitation for brain research workers concerned with Java monkeys. A. J. McCoMAS

AND G. H. BOURNE, iv + 68 pages, 64 illustrations, Karger, Basle, 1968, Sfr/DM 38.--, 69s. Hitherto a large proportion of the neuroanatomical and neurophysiological studies on primates have been performed on Rhesus monkeys (Macaca mulatta). During recent years, however, the Java or cynomolgus monkey (Macaca irus) has become increasingly favoured by research workers since it possesses a number of advantages over the Rhesus animal. Thus the Java monkey is cheaper to purchase and maintain, and is also easier to handle. On the other hand the Java monkey is smaller than the Rhesus species and the cerebral convolutions are less prominent, though the main sulci and gyri are still easily i ecognizable.

Neuroradiology Workshop, Vol. 3 (Non-neoplastic Intracranial Lesions), by L. M. DAVIDOFF, H. G. JACOBSON AND H. M. ZIMMERMAN, vi ~577 pages, 184 illustrations, Grune and Stratton, New York, London, 1968, $ 34.75.

This is one of a series of 4 volumes covering the field of neuro-radiology, Vol. 3 being concerned with the diagnosis of non-neoplastic intracranial lesions. The book is dived into 6 chapters each dealing with a group of conditions with a common

J. neurol. Sci (1969) 8:598-606