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Epilepsie 1979. Ehe, Schwangerschaft, Geburt, genetische Beratung
Electroencephalography and Clinical Neurophysiology, 1981, 52: 105--106
105
Elsevier/North-Holland Scientific Publishers, Ltd.
BOOK REVIEWS
edited by H. PETSCHE and JOHN R. HUGHES Epilepsie 1979. Ehe, Schwangerschaft, Geburt, genetische Beratung. -- H. Doose, M. Dam, G. Gross-Selbeck, H. Meinardi (Eds.) (Georg Thieme Verlag, Stuttgart, 1980, viii, 122 p., 26 fig., 36 tab., DM 30.-) The topics listed in the title belong to the most important problems of epileptology. They are both interesting from the theoretical point of view and urgent in current practice. Some of them have been discussed in the past years with controversive opinions (e.g., teratogenic influence of antiepileptic drugs, etiological significance of heredity in different types of epilepsy, risks of gravidity for mother and child etc.). All these questions are discussed in this volume in concise lectures. Original contributions as well as useful reviews of individual topics are reported with pertinent conclusions for medical practice. Some of the most interesting conclusions are as follows: a teratogenic effect of antiepileptic drugs has not yet been verified beyond any doubt; it is possible that the elevated rate of congenital malformations is not correlated with drugs, but with the epileptic disease. No differences between different drugs were demonstrated with respect to their supposed teratogenic effect; a change of the pharmacotherapy during gravidity is therefore not recommended. The risk of impairment of embryonal development by epileptic seizures of the mother may be higher than the supposed teratogenic effect of drugs -- the dose of drugs should therefore not be diminished. The reading of these proceedings can be recommended to all research workers in epileptology as well as to all neurological practitioners. Z. SERVfT
Institute of Physiology, Czechoslovak Academy of Sciences, Prague (Czechoslovakia) Practical electromyography. -- E.W. Johnson (Ed.) (Williams and Wilkins, Baltimore, Md., 1980, 457 p., U.S. $ 39.00) This volume, one of a series entitled 'Rehabilitation Medicine Library,' is a considerably altered successor to the first book on electromyography produced solely for physiatrists by Sidney Licht in 1950. The
present volume is also written by and for physiatrists. The authors are students or associates of the editor and, as the editor notes, some of their writing is more authoritarian than authoritative. A certain amount of 'cool aloofness' exists between the neurology and physiatry establishments, which is unfortunate. However, it is seen particularly clearly in the field of electromyography which, in this country, developed largely amongst physiatrists. Only during the past decade have physicians trained in neurology demonstrated increasing interest in electromyography. Having dismissed any inter-specialty controversies as puerile, I must admit there are very considerable differences in the approaches typical of each specialty to the technique and body of knowledge defined as electromyography. These differences are exemplified in this book written by 19 authors, one of whom was trained in neurology. Those chapters, the content of which falls largely outside this controversy, such as the history of electrodiagnosis up to about 1960 written by Dr. Licht and technical or instrumentation aspects by Reiner and Rogoff, are generally excellent. The chapter on myopathies is good and that dealing with anterior horn cell diseases is better than many of the rest. Each chapter contains, where appropriate, considerable description of clinical diagnostic and therapeutic methods. Physiatrists feel an EMG examination should end with a suggestion to the referring physician concerning therapy of management. For example, the representative EMG report concludes 'right C-7 radiculopathy-moderate, should respond to traction.' It is not possible to review each chapter in detail but the following comments may be illustrative. A number of neologisms are found in this book which are difficult for an electromyographic outsider to understand. For example, how many would know that a 'ratchety response' is pathognomonic of hysterical paralysis, or what the author means by 'iterative fasciculations', let alone could list 3 syndromes in which they are seen? Is it generally acceptable for the loss of motoneurones caused by syringomyelia to be termed a 'motor neuropathy'? Why have the authors perpetuated one of the rare errors emanating from the Mayo Clinic where the Roussy-Levy syndrome was mistakenly re-defined as Charcot-Marie-Tooth neuropathy plus essential tremor? Selective citation (defined as 'quoting references written by your friends and ignoring those written by others') and the use of old
0013-4649/81/0000--0000/$02.50 © Elsevier/North-Holland Scientific Publishers, Ltd.
105
Elsevier/North-Holland Scientific Publishers, Ltd.
BOOK REVIEWS
edited by H. PETSCHE and JOHN R. HUGHES Epilepsie 1979. Ehe, Schwangerschaft, Geburt, genetische Beratung. -- H. Doose, M. Dam, G. Gross-Selbeck, H. Meinardi (Eds.) (Georg Thieme Verlag, Stuttgart, 1980, viii, 122 p., 26 fig., 36 tab., DM 30.-) The topics listed in the title belong to the most important problems of epileptology. They are both interesting from the theoretical point of view and urgent in current practice. Some of them have been discussed in the past years with controversive opinions (e.g., teratogenic influence of antiepileptic drugs, etiological significance of heredity in different types of epilepsy, risks of gravidity for mother and child etc.). All these questions are discussed in this volume in concise lectures. Original contributions as well as useful reviews of individual topics are reported with pertinent conclusions for medical practice. Some of the most interesting conclusions are as follows: a teratogenic effect of antiepileptic drugs has not yet been verified beyond any doubt; it is possible that the elevated rate of congenital malformations is not correlated with drugs, but with the epileptic disease. No differences between different drugs were demonstrated with respect to their supposed teratogenic effect; a change of the pharmacotherapy during gravidity is therefore not recommended. The risk of impairment of embryonal development by epileptic seizures of the mother may be higher than the supposed teratogenic effect of drugs -- the dose of drugs should therefore not be diminished. The reading of these proceedings can be recommended to all research workers in epileptology as well as to all neurological practitioners. Z. SERVfT
Institute of Physiology, Czechoslovak Academy of Sciences, Prague (Czechoslovakia) Practical electromyography. -- E.W. Johnson (Ed.) (Williams and Wilkins, Baltimore, Md., 1980, 457 p., U.S. $ 39.00) This volume, one of a series entitled 'Rehabilitation Medicine Library,' is a considerably altered successor to the first book on electromyography produced solely for physiatrists by Sidney Licht in 1950. The
present volume is also written by and for physiatrists. The authors are students or associates of the editor and, as the editor notes, some of their writing is more authoritarian than authoritative. A certain amount of 'cool aloofness' exists between the neurology and physiatry establishments, which is unfortunate. However, it is seen particularly clearly in the field of electromyography which, in this country, developed largely amongst physiatrists. Only during the past decade have physicians trained in neurology demonstrated increasing interest in electromyography. Having dismissed any inter-specialty controversies as puerile, I must admit there are very considerable differences in the approaches typical of each specialty to the technique and body of knowledge defined as electromyography. These differences are exemplified in this book written by 19 authors, one of whom was trained in neurology. Those chapters, the content of which falls largely outside this controversy, such as the history of electrodiagnosis up to about 1960 written by Dr. Licht and technical or instrumentation aspects by Reiner and Rogoff, are generally excellent. The chapter on myopathies is good and that dealing with anterior horn cell diseases is better than many of the rest. Each chapter contains, where appropriate, considerable description of clinical diagnostic and therapeutic methods. Physiatrists feel an EMG examination should end with a suggestion to the referring physician concerning therapy of management. For example, the representative EMG report concludes 'right C-7 radiculopathy-moderate, should respond to traction.' It is not possible to review each chapter in detail but the following comments may be illustrative. A number of neologisms are found in this book which are difficult for an electromyographic outsider to understand. For example, how many would know that a 'ratchety response' is pathognomonic of hysterical paralysis, or what the author means by 'iterative fasciculations', let alone could list 3 syndromes in which they are seen? Is it generally acceptable for the loss of motoneurones caused by syringomyelia to be termed a 'motor neuropathy'? Why have the authors perpetuated one of the rare errors emanating from the Mayo Clinic where the Roussy-Levy syndrome was mistakenly re-defined as Charcot-Marie-Tooth neuropathy plus essential tremor? Selective citation (defined as 'quoting references written by your friends and ignoring those written by others') and the use of old
0013-4649/81/0000--0000/$02.50 © Elsevier/North-Holland Scientific Publishers, Ltd.