Electrodiagnosis. An anatomical and clinical approach

88 Electrodiagnosis. An anatomical and clinical approach. - - J. Chu-Andrews and R.J. Johnson (Lippincott, Philadelphia, PA, 1987, 444 p.) The book is divided in 2 parts: in the first (Anatomy, Ch. 1 and 2) a very detailed study of applied and clinical anatomy of the muscular system is presented. These two chapters represent half the book and provide a comprehensive photographic anatomical arias which will be useful to any electromyographist. Illustrated dissections on cadavers are superb and the photographic work is excellent; only one printing error was detected on p. 55, Fig. 1-49 ('semitendinous' stands for 'semimembranous' and vice versa). Chapter 2 completes this description with photographs of clinical muscle anatomy in living subjects and illustrates for each muscle the most appropriate site for needle insertion. Also in this chapter are provided precious instructions to be given to the patient to obtain relaxation as well as minimal or maximal contraction of each muscle. These instructions are perfectly described and represent one of the best innovations of the book. The 'How to do' procedural descriptions along with the excellent photographic work will undoubtedly help the examiner in the correct localization of difficult muscles. The second part of the book (Clinical Electrodiagnosis, Ch. 3-7) is more irregular. Some subjects are treated with remarkable precision and clarity. Commonly encountered technical problems (reduction of amplifier common-mode rejection when using concentric electrodes; influence of reference electrode, filter settings and sweep time on potential shape and latency measurements) are analysed in detail. The section devoted to motor unit analysis is envisaged in a section of 16 pages containing straightforward and very useful information, as well as normative data on monopolar recordings not previously available in most textbooks. One can only regret that MUP data in subjects over 60 years old are derived, mostly of the muscles, from only 5 controls. Some topics such as the pathophysiology of fibrillating potentials (p. 213) or the differentiation of benign from malignant fasciculations (p. 214) are treated in a rather schematic way that might give the impression of unnecessary dogmatism. Some of the references cited to support the authors' opinions on issues which are still matters of controversy have been contested. Comments on conduction velocity differences after stimulation with needle or surface electrodes (p. 201) do not take into account alternative proposals from the literature. Readers seeking some synthetic insight into existing controversies in the field should turn to other complementary books. The reviewers agree that a textbook must privilege clear and positive statements, but also feel that the reader should know whether the authors' views are agreed upon by the scientific community. Surprisingly lead neuropathy in which demyelination is a constant feature is studied under the heading of axonal neuropathies. Some sections are a bit repetitive and, for example, in Ch. 4 details about sweep time or filter settings are repeatedly exposed before each new nerve conduction procedure is studied. This can be justified, however, since the authors want the book to be a reference text for the 'busy clinician.' Such repetitions

BOOK REVIEWS entail a few printing errors; for instance in p. 334, 'cathode distal' should be 'cathode proximal.' Detailed descriptions of the applied anatomy of 22 peripheral nerves given in Ch. 4 are of great help for understanding the mechanisms of entrapment neuropathies. In summary, this is a very useful book for everyone practising, or willing to practise clinical EMG. If a text is needed for extensive description of muscle and nerve anatomy, technical EMG procedures and normative data, this is the one. The title of the book is somewhat misleading, and it should read 'Peripheral electrodiagnosis' since the material presented concerns only EMG and electroneurography. L. Garcla-Larrea and F. Mauguitre

EEG Department, H~pital Neurologique, F-69003 Lyon (France)

Atlas of mobile long-term EEG recordings (Arias mobiler Langzeit-EEG-Ableitungen). - - H. Stefan and W. Burr (Fischer, Stuttgart, 1986, 275 p.) This book provides a comprehensive description of mobile EEG cassette monitoring, a technical development which during the last years has got more and more clinical importance. Although generally 24 h cassette recording is only part of EEG technique, there will be a couple of newly arranged aspects which have to be accounted for, if this method is to be successfully introduced into clinical practice. The main interest of the authors is to assist their colleagues in other laboratories who are going to do this step. Hence, the practical application is considered to be most important, which fact is also reflected by the partition of the single chapters. The text part is kept relatively short (English and German), though including a compressed survey over the historical development of the intensive care monitoring as well as useful chapters concerning technical and practical problems of artifact reduction and discrimination, and evaluation difficulties. The major part is dedicated to the presentation of recording examples, including a wide selection of epileptic and nonepileptic forms of ictal EEG patterns. This might be of great help in evaluating and correlating the reader's own findings. The examples printed in high quality and well comprehensible are selected very close to practice, sometimes including even tracings with artifacts. In order to avoid classification problems the arrangement is not strictly systematic: more often individual eases are described in connection with their variable polygraphic findings. Since the number of included syndromes is considerable the user may find answers to many of his own diagnostic problems. Although some seizure syndromes of infancy and childhood are represented as well, the book mainly concerns findings in adolescents and adult patients. Summing up, this book should not be regarded as in