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Atlas of sleep medicine.

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Atlas of Sleep Medicine
Edited by Sudhansu Chokroverty, Robert J. Thomas, and
Metea Bhatt
Philadelphia, Elsevier, 2005
352 pp, illustrated, $95.00
The object of Atlas of Sleep Medicine as stated by the editors
was to “produce a comprehensive contemporary atlas illustrating numerous examples of polysomnogram and other
tracings accompanied by sufficient clinical details so that the
reader can formulate a clear view of the big picture.” This
atlas is divided into 13 chapters covering techniques, clinical
pattern recognition, continuous and bilevel positive-airway
pressure titrations, and polysomnogram (PSG) variations.
Chapter 1 starts with the basic techniques of PSG recordings. The technical aspects of setting up a polysomnogram,
identifying the purposes for each procedure or monitoring device, as well as their weakness and strength, are presented in a
concise manner. The illustrations of PSG recording include
demonstrations of different stages or artifacts. Chapter 2 focuses on wake-sleep physiological activity using 16 channels of
electroencephalogram (EEG) recordings. The examples of the
recordings are presented to display EEG speeds at both 10
sec/page and 30 sec/page. The strength of this chapter is the
discussion of EEG artifacts. This will be most helpful to sleep
specialists who do not have significant prior EEG training.
Chapters 3 to 8 flow easily from the general technical aspects of the preceding two chapters to the more specific aspects of sleep recordings. A major strength of these chapters is
the depth of the details given and the simplicity with which
the information is delivered. A good example is the discussion
of the EEG/electrooculogram (EOG) recording. They tell you
why the EOG voltage is higher than the EEG. They talk
about the polarity and why you get differing degrees of signal
deflections. They present basic information about frequencies
and reasons for selecting filters. They also deal with respiratory, leg movement, cardiac, and oximetry channels in similar
detail, starting with simple technical explanation of the signal
and then discussing limitations and interpretations with plenty
of examples. Chapter 9 and 10 are devoted to seizure and
other neurological disorders and their consequences on sleep–
wake PSG. Chapters 11 goes where most atlases have yet to
tread, presenting discussions of specialized techniques: actigraphy, cyclic alternating pattern, use of pulse transit time, and
peripheral tonometry. Chapter 12 is a discussion with practical
illustrations on the application of continuous positive airway
pressure and bilevel positive airway pressure therapy. The concluding chapter again is an excellent presentation through the
use of illustrations of pediatric sleep–wake PSG.
Overall Atlas of Sleep Medicine is well-written, excellently
illustrated and up-to-date, with a depth of detail that sets it
apart from other atlases. It provides value to any and all who
wish to advance their knowledge of the technical and electrophysiological aspects of sleep–wake monitoring.
DeJong’s The Neurologic Examination
By William W. Campbell
Philadelphia, Lippincott, 2005
720 pp, illustrated, $110.00
In the sixth edition of Russell N. DeJong’s classic book on
the neurological examination, Dr William W. Campbell,
Professor and Chairman of the Department of Neurology,
Uniformed Services University of Health Sciences, has revised and updated a textbook that has endured for over 50
years. In his preface, Dr Campbell points out that currently
neurologists practice “MRI negative neurology”, that is, primary care and emergency room physicians obtain a computed tomography or magnetic resonance scan in response to
essentially any neurological complaint. Hence the “easy diagnoses” often come from this source. It requires the skill of a
clinical neurologist to make a diagnosis and institute therapy.
Accordingly, Dr Campbell believes, and I concur, that the
neurological history and examination are alive and well.
Moreover, in recent years the gratification that clinicians receive from neurological practice is not only making an astute
diagnosis, but also in instituting therapy. Approaching the
task of revising DeJong’s The Neurologic Examination, Dr
Campbell planned to shorten it, but in the end chose instead
to augment and update the work. To his credit, Dr Campbell has retained many of the fine points about the neurological examination, augmenting them with up-to-date illustrations and anatomical points.
The outline adheres to that used in earlier editions, proceeding in the sequence by which most clinicians conduct
the examination. Dr Campbell has introduced many new tables and illustrations while retaining those that were effective
from the older editions. Updated discussions of coma (Chapter 51) and diagnostic reasoning and differential diagnosis
(Chapter 53) are particularly well done. The remaining chapters have been revised and new references have been added,
many of them relatively recent, but I found none more recent than 2003. DeJong’s The Neurologic Examination retains
many useful older vintage references. Moreover, Dr Campbell has included a large number of clinical signs identified
with proper names, many of the signs obscure and never discussed but nevertheless useful for an encyclopedic treatise
that has both current and historical interest. Inevitably, some
parts are not up-to-date with current thinking. For example,
the author does not mention current concepts about the flow
through the basal ganglia of information specific to particular
motor circuits, and Figure 26.4 contains errors in identification of neurotransmitters. Also, the author did not include
current concepts of role of the cerebellum in cognitive functions. These are minor problems in an otherwise worthy revision.
Many students, residents, and practicing neurologists will
find DeJong’s The Neurologic Examination to be an excellent
addition to their libraries. It contains a treasure trove of interesting information that the neurological clinician will appreciate having available.
Christopher Earley, MD, PhD
Baltimore, MD
Sid Gilman, MD, FRCP
Ann Arbor, MI
DOI: 10.1002/ana.20717
DOI: 10.1002/ana.20718
© 2006 American Neurological Association
Published by Wiley-Liss, Inc., through Wiley Subscription Services
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medicina, atlas, sleeps
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