Single fibre electromyography, 2nd ed
Forward looking departments are advised to obtain copies of the new edition. LEO DAVIES Camperdown
Stalbery E, Trontelj J Raven Press, 1994 ISBN 0 781 70212 7 291pp RRP $190.00 Dr Erik Stalberg was responsible for the development of the technique of single fibre electromyography. The first edition of this work which was published in 1979 was written in collaboration with Dr Joze Trontelj and has been the gold standard reference text for single fibre electromyography since it appeared. Since its publication Dr Stalberg and Trontelj have remained in the forefront of single fibre electromyographic research. The new e d i t i o n has b e e n eagerly awaited by neurophysiologists a r o u n d the world. Although much of the basics of single fibre e l e c t r o m y o g r a p h y r e m a i n u n c h a n g e d , the r a p i d advances in the t e c h n o l o g y of EMG m a c h i n e s have r e n d e r e d m a n y of the t e c h n i q u e s described in the first edition less relevant. The second edition brings single fibre e l e c t r o m y o g r a p h y into the r e a l m of contemporary neurophysiology laboratories based a r o u n d micro c o m p u t e r technology. This e d i t i o n c o n t a i n s a substantial n u m b e r of new illustrations and some clarification of the original text as well as comprehensive new sections dealing with advances in macro EMG and scanning electromyography. The largest clinical application of Dr Stalberg's work continues to be in the diagnosis of myasthenia gravis and the text provides an invaluable reference for neurophysiologists conducting studies on p a t i e n t s s u s p e c t e d of h a v i n g this c o n d i t i o n . An e n l a r g e d r e f e r e n c e of n o r m a l r a n g e s for j i t t e r values in a selection of skeletal muscles has been gathered by a collaborative effort amongst a n u m b e r of EMG laboratories and will be most helpful for the clinical neurophysiologist. T h e b i b l i o g r a p h y has also b e e n revised a n d s u b s t a n t i a l l y updated. While this text is primarily aimed at clinical and research neurophysiologists, it is so clearly written that it will be easily understood by any physician interested in diseases of muscle or the neuromuscular junction. The book is obligatory for all EMG laboratories a n d clinical neurophysiologists a n d is strongly recommended to any clinician who is likely to request single fibre electromyographic studies. The first edition of this book passed out of print and copies became highly prized by trainee neurologists.
Movement disorders 3 Marsden C D, Fahn S Butterworth-Heinemann UK, 1994 ISBN 0 750614 12 9 529pp RRP $110.00 This is a very good update in the area of movement disorders compiled by two of the world's leaders in this field. There are some 35 contributing authors, many being amongst the best in their own particular subspecialty areas. Movement disorders 3 besides being an update is in part also the continuation of the early 2 movement disorder volumes. This is a more than welcome addition to those. There are 25 chapters divided into three parts. Part I deals with general aspects in 5 chapters covering: anatomy, experimental models, genetic aspects, functional imaging, and eye movement disorders. Part II covers the akinetic-rigid syndromes in 9 chapters with regard to Parkinson's disease: problem areas, epidemiology, pathology, neuroprotection, improved dopaminergic therapy, transplant research and clinical aspects. T h e 2 r e m a i n i n g chapters deal with multiple system atrophy and corticobasal ganglioma degenerations. Part III deals with dyskinesias in 11 chapters including: problem areas, paroxysmal dyskinesias, differential with epileptic syndromes, p s y c h o g e n i c disorders, stiff p e o p l e , peripheral movement disorders, startle syndromes, odd tremors, spinal myotomes botulinum toxin therapy, and stereotypies. In general, the chapters are concise, well laid out, up to date and very readable. I believe that this together with the previous and future volumes will make a very reasonable set of reference texts in this area for practising neurologists. DAVID SERISIER Wollongong
Epilepsy and quality of life Trimble M R, Dodsen E W Raven Press, 1994 ISBN 0 781 70175 9 306pp RRP $252.00 This book represents the material presented at an international workshop held in America in April 1993. It tries to be all-
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embracing with a broad ranging approach which starts with more general concepts of patient and family perspectives, assessm e n t of c h r o n i c disability a n d its influence u p o n the family, together with compliance and approaches directed to its assessment. Following the introductory chapters, the book goes on to discuss the evaluation of quality of life (QOL) tools before discussing specific health-related quality of life instruments designed for use in. the assessment of patients with epilepsy. T h e initial chapters lack the flair necessary to encourage the reader to persevere and the faint hearted may lose i n t e r e s t at this p o i n t . T h e o p e n i n g chapters are a little too 'all encompassing' and somewhat basic for the informed reader, who does not want to be educated as to the nature of QOL, but rather seeks specific information as to recommended available tools, their application and their evaluation in epilepsy as is implied in the title of the text. The endurance to continue reading the book, is rewarded with excellent chapters which deal with the evaluation of health-related and specific QOL tools and dissertations by the experts who developed such instruments and who are given free reign to discuss their respective products. The book provides the reader with a valuable reference text which offers considerable insight into a variety of instruments which have b e e n developed to assess health-related quality of life within epilepsy. Perhaps a shortcoming is that, having provided the evaluative procedure, as per Chapter V, entitled 'Some Statistical Issues in Quality of Life Measures', the subsequent chapters, dealing with individual tools, are not analysed according to the guidelines as devised within the body of the text. While this is understandable in a 'proceedings' textbook, it does detract from the value of the overall contribution, as it does not allow the reader to chose between tools with any degree of objectivity (recognising that each tool is presented by its protagonist). The editors completed the work with an 'Epilogue' which addresses some of the criticisms raised above, and in their own words '...although this was not ideal, it emphasizes several aspects that were considered important for QOL in epilespy...' They go on to say that only the tool developed by Vickrey is a strict QOL tool for epilepsy and they questioned the validity of such tools as the W a s h i n g t o n Psychosocial Seizure Inventory.
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The editors recapitulated the many questions that this text has generated and which still c i r c u l a t e a m o n g s t those working in the field of QOL, especially h e a l t h - r e l a t e d QOL as it applies to epilepsy. T h e i r final c o m m e n t r e m a i n s the pivotal issue, in that the optimum tool has n o t yet b e e n develped. T h e editors recognise that an explosion of energy, directed at it development, has the inherent risk that there will be as many scales as there are investigators. My final comment, as a reviewer of this text, is that it is hard to justify the cost of $252.00 for a text such as this, despite the fact that it is a very welcome addition to the library for anyone with special interest in h e a l t h - r e l a t e d q u a l i t y of life measurement in epilepsy. ROY BERAN Sydney
Evoked potential primer 2nd ed
although by no means extensive list of references at the end of each section. This book provides an excellent introduction to sensory evoked potentials for teaching and practice purposes. Its style and presentation make for easy reading and quick access. It does not, however, address variations in methodology or nonpathologic factors affecting results in enough detail to satisfy as a sole reference for n e u r o l o g i s t s or c l i n i c a l n e u r o physiologists. T h e r e f o r e , for those n e u r o l o g i s t s who already have basic knowledge of evoked potentials, the text by Chiappa K. (Evoked potentials in clinical medicine) remains the reference of choice. This book is a useful introduction for medical and paramedical personel interested in the principles and clinical use of evoked potentials in the diagnostic evaluation of patients with neurologic diseases. It is recommended reading for neurology and n e u r o s u r g e r y trainees, neurophysiology technicians and other physicians who want to learn how to record and interpret evoked potentials. LYN KIERS Melbourne
Misulis K Butterwor th-Heinemann, 1994 ISBN 0 750695 12 9 243pp RRP $85.00 This single author book is an excellent introduction to the theory; methods, interpretations and diagnostic utility of sensory evoked potentials. It is an update of Spehlmann's original evoked potential primer of 1985, with a brief chapter added on motor evoked potentials, The book is divided into five sections: A) general principles, which includes a discussion of evoked potential generators and principles of signal averaging; B) visual evoked potentials; C) auditory evoked potentials; D) somatosensory evoked potentials; E) event-related and other potentials including a brief introd u c t i o n to m o t o r evoked potentials. There is no section on intraoperative monitoring, perhaps reasonably because it is now considered as a specialty of its own. Each section describes the general methods of stimulating and recording, as well as interpretation of normal and abnormal responses. There is an adequate,
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Stroke in children and young adults Billet J, Mathews KD, Love B B Butterworth-Heinemann USA, 1994 ISBN 0 7506 9203 0 259pp RRP $135.00 Stroke, the most common serious neurological disorder, predominantly affects middle-aged and older adults. However, a significant proportion of strokes occur in young adults, adolescents and even children. For example, 3% of patients with cerebral infarction are u n d e r the age of 40 years. The prognosis after stroke in children and young adults is substantially better than in older age groups. The pathogenic mechanisms are often different from those in older populations and hence require different approaches to diagnosis, primary and secondary prevention, and acute therapy. In contrast to the major risk factors in older patients, n a m e l y h y p e r t e n s i o n ,
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atherosclerosis and cardiac disease, there is a large n u m b e r of h e t e r o g e n e o u s aetiologies which need to be considered when the clinician is confronted with a young adult stroke patient. Cardiac embolism is the most c o m m o n cause of ischaemic stroke, responsible for approximately 50% of childhood and young adult cerebral infarcts, while other common aetiologies include arterial dissection, migraine and hypercoagulability states. Atherosclerosis is a relatively rare cause. While these topics are often reviewed in larger textbooks on stroke and more briefly in internal medicine texts, Biller, Mathews and Love have written a most useful book, which would be a value to any clinician who regularly m a n a g e s patients with cerebrovascular disease. Most chapters are written by the three authors, unlike the majority of current stroke t e x t b o o k s which are m u l t i authored and hence less cohesive. There are useful contributions from other stroke authorities on cerebral infarction and migraine, cerebral venous thrombosis and s u b a r a c h n o i d h a e m o r r h a g e in young adults. The chapter by Biller on nonatherosclerotic vasculopathies is a particularly useful review of diseases such as flbromuscular dysplasia, cervicocephalic arterial dissections, Moyamoya disease a n d c e r e b r a l vasculitis, i n c l u d i n g a p p r o a c h e s to a c u t e i n t e r v e n t i o n a l therapy. There is also a particularly valuable chapter on stroke and pregnancy. Cerebral venous thrombosis occurs in one of every 10 000 deliveries in N o r t h America and there is a similar incidence of ruptured intracranial aneurysm. In summary, this is a concise yet comprehensive and well integrated textbook with an up to date bibliography. It is not encyclopaedic in scope or length, but covers all of the majortypes of stroke in young adults. The tables and illustrations are relevant and helpful. This book can be recommended as a valuable addition to the library of any clinician involved in the m a n a g e m e n t of stroke, as well as trainee neurologists and neurosurgeons. STEPHEN DAVIS Melbourne