Stereotactic treatment of epilepsy

445

Neural and Behavtoral Spectfictty (Studtes on the Development of Behavior and the Nervous System, Vol 3), by G Gottheb (Ed), XVlt + 352 pages, 42 illustrations, 18 tables, Academic Press, New York, San Francisco, London, 1976, US$ 28 50, £ 15 70 Thas is Volume 3 in the series Studies on the Development of Behavlour and the Nervous System Edated by a psychologist, Gilbert Gottheb, and entitled Neural and Behavtoral Spectfictty at as, m fact, mainly concerned with development of specificity of neural functioning underlying vasual perception, only one of 5 sections referring to auditory perception and taking broader aspects of behavloural development into conslderataon The Volume is de&cated to C Judson Hernck whose seminal contrabutaons to the field are described an a five page blographacal apprecmtaon Each of the 4 main sections consists of two chapters preceded by a brief mtroductaon by the Editor The first section deals with hastorlcal and theoretical aspects rooted an the natlvasm/empancasm controversy which ~srelated m this context to contemporary anterest in functaonal specaficlty of neurons and their specafic anatomical mterconnectaons in the pathways subserving perceptaon The first, hastoracal chapter by Llppe stresses the now recogmsed need for a developmental analysas of the role of experaence and thas theme is dealt with specafically m the second chapter by Gottheb himself He points out that the questions are not of a simple yes-no nature and that experaence can have various developmental roles, sustaining, facdltatmg or determining the course of development, or modifying already mature structures or functaons The second sectaon m two chapters, by Keatmg and by Meyer and Sperry respectwely, deal w~th the chemoaffimty theory of neurospecaficaty According to thas theory, for example, the regularity of neuronal lnterconnectlons between the retina and hagher vasuai centres ~s due to pre-programmed cytochemlcal "labelhng" selectavely determining the formataon of synapses Although thas theory is equally applacable to mammahan development, at is more easdy tested by surgical anterventlons during the early embryonic stages of the eggs of fish and amphabmns Section 3 turns again to the role of experience and to vasual specafic~ty m mammals Grobstem and Chow consader the vasually naave anamal and the effects of abnormal vasual experaence and Darnels and Pettlgrew consider especmlly the effects of monocular depnvataon and the concept of a cntacal period Whereas there as no dispute that binocular fusaon Is experaence-dependent the same cannot be sa~d of the other 3 mare wsual neural specafic~tJes, onentataon specaficaty, d~rect~on of motaon specaficaty and binocularity, the actwataon of a cell vm one or both eyes Section 4 has a more behawoural onentataon Another Chapter by the E&tor as concerned wath the role of early au&tory experience m specaes-speclfiC preferentml responses to maternal calls Then Tees revaews all research on the role of experaence an the vmual and auditory perceptual development of mammals, concentrating on the methodologacal assues The problems of experimental desagn are clearly immense and ensure that results are seldom decaslve Depr~vataon experiments only provade a starting point for developmental analysas and need to be followed by longitudinal experimental anterventlons The ffth, final sectaon as a brief two page summansmg epilogue by the E&tor and rounds off a book whach provades a very useful and readable account of an exciting area of rapadly advancmg contemporary psycho-baologlcal research H Gwynne Jones

Stereotacttc Treatment of Eptlepsy (Symposmm under the Sponsorship of the European Society for Stereotactlc and Functional Neurosurgery, Bratlslava, 1975) (Acta Neurochlrurgtca, Supplement No 23), by F J Gllhngham, E R Hltchcock and P Nfidvornlk (Eds), Vl + 281 pages, 99 dlustratlons, Sprmger-Verlag, Vienna, New York, 1976, S 966 00, DM 140 00, US$ 57 40 In 1975 a Symposmm was held at Brataslava m Czechoslovakta, under the auspices of the European Society of Stereotactlc and Functaonal Neurosurgery This volume, which was published at the end of last year, contains the papers g~ven at the Meeting Its locataon was reflected to some extent m the sources of the contributions, 22 of whach are from East Europe, 11 from West Europe, 5 from the Umted States, 3 from Japan and 1 from India It provaded an excellent forum for the exchan-

446 ge of knowledge and experience between workers m slmdar fields ~ho often have d~fficulty m corn mumcatmg with each other The problem of target selectaon for the stereotactic treatment of epdespy was naturally a ttcurrmg theme, and was approached from various d)rections Information derwed from acute and chromcally implanted electrodes figures m several reports, and these mlplanted electrodes were used for recording actwlty, for st~mulataon, and for lesion making There are papers describing the value ot EEG analys~s, averaging of mtenctal mformataon, the use of telemetry, and other techmques for obtaining the maximum benefit from thas source, which as rapidly being ousted as a dmgnoshc tool from most other fields except that of epilepsy There are several papers on the physiological aspects of the subject, including the relation o! catecholammes and GABA to epilepsy, and the mode of spread of seazures This work includes both animal and human materml As might be expected, there are ~mportant papers on the results of stereotactac surgacal method~ from West Germany and Japan, but these are only some of the sources of valuable material contained in the book The targets used include the amygdala, the anteraor commissure, the H-field of Forel and the h~ppocampus, among others Thas well-produced book is a record of the range of interest and the state of knowledge of the subject at the present time It should be read by anyone concerned with physacal methods for the treatment of epdepsy and by those carrying out experamental work m thas field It Is not in the nature of a symposium of th~s kind to draw conclusaons, nor are we yet m a posmon to do so However, the Bratislava Meeting must be regarded as one of those occasaons when workers could take stock of the situahon There is much to be learnt before the role of stereotact~c surgery an thas context can be clearly defined, and ~ts dmgnostic uses may not be the least ~mportant, for they could provide a gwde to the better use of pharmacologacal agents m the future The abxl~ty of the brain to adapt to a new s~tuation is a factor which mdltates against the benefits of lesaons designed to prevent the spread of seazure actwity, but more knowledge of the role of the amygdala and central deep structures may enable a rational rather than an empirical approach to be made to the wider apphcataon of surgery m thts field P H Schurr

Structure o f the Human Bram - - A Photographic Atlas, 2nd edition, by S J DeArmond,

M M Fusco and M M Dewey, v q- t86 pages, 103 tllustratlons, Oxford Untverslty Press, London, New York, 1976, $ 5 95 It Js pleasant to be able to recommend unreservedly a book one has been asked to review, and also to be able to say that the contents lave up to the t~tle as this one does at certainty as a photographic atlas of the human bram In the present carcumstances of high inflation ~t as rare to find the price to be reasonable and a book that is good value for money The book consists of almost 100 photographs with an accompanying labelled lane drawing opposate each, clearly indicating the structures shown The photographs are of hagh quahty and are of the various surfaces of the brain, some gross dlssectaons, sections of the cerebral hemisphere m different planes, and of hastologlcal sections of the brain and spinal cord stained for cells or fibres In their Introduction, which is the only text in the book, the authors state that the mare reason for the second edmon was "to include neuroanatomical mformataon needed for interpretations of the new chnlcal investigative method, computer~_ed brain tomography (CT brain scanning)", and this they have done by including 4 CT scans and photographs of 9 sections of the brain cut m the plane of computerized tomography The blood supply Js emphasazed throughout and one section is devoted to it with several ang~ograms, the only crmc~sm refers to thas section, because it is unfortunate that for some techmcal reason the pubhshers have got some of the lane dmgrams upside-down It Is probably true to say that most medical undergraduates and graduates find it difficult to understand the three-dimensional structure of the brain, and any dlustratlons that really help will be of value The present work should do this not only for medical students and neurotogtcal trainees, but for anyone whose work is concerned with the central nervous system including chmctans, neuropathologlsts and neurorad~olog~sts It should be available m the hbranes of actave neurologlcaI centres T P S Powell