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Brain mapping The methods. Arthur W. Toga and John C. Mazziotta San Diego CA Academic Press 1996 471 pp illustratred $145

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followed by specific chapters on types of pain syndromes and
therapies, making the book flow nicely from start to finish.
In addition, each chapter stands alone as an extensive review
of current day “theory and practice” of pain management,
with suggested diagnostic assessment tools and therapies,
along with encyclopedic bibliographies.
Several chapters are to be particularly commended for
their breadth and writing style. Pain medicine literature, especially in the clinical realm, is often complex and confusing,
due to poor scientific study. However, the several chapters
written by D r Portenoy and Dr Kanner bring logic and common (clinical) sense to the topics of “Definition and Assessment of Pain,” “Basic Mechanisms,” “Neuropathic Pain,”
“Low Back Pain,” “Nonopioid and Adjuvant Analgesics,”
and “Opioid Analgesics,” without sacrificing an intelligent
discussion of available scientific and anectodal study. Other
well-written pieces include cancer pain pioneer Dr Kathleen
Foley’s “Pain Syndromes in Patients with Cancer,” fibromyalgia expert rheumatologist D r Frederick Wolfe’s “Fibromyalgia and Myofascial Pain Syndrome,” well-respected pain
anesthesiologists Drs Sutton and Cousins’ “Anesthetic Techniques for Pain Control,” internationally known Dr Ronald
Tasker’s “Surgical Approaches to Chronic Pain,” and pain
expert psychologists Drs Turk and Nash’s “Psychological Issues in Chronic Pain.”
By including such regarded figures in the field of pain
medicine who are not neurologists, Drs Portenoy and Kanner, it is hoped, will open the eyes and minds of fellow
neurologists who often are only taught how to approach patients with pain from a narrow neurologic perspective; ie,
“where is the lesion?” and “what laboratory tests do I need
to order?” Throughout the text, the clinical and mechanistic
pitfalls to this approach are evident. As the editors and their
co-authors readily point out, much pain therapy is still often
based on poor scientific data. However, much has been
learned over the past few decades, from animal model study,
large clinical experience, and more recent controlled clinical
trials, that allow pain experts to make well-grounded therapeutic suggestions.
In conclusion, Pain Management: Theory and Practice is
highly recommended to all neurologists who care for chronic
pain patients. This pain medicine monograph is comprehensive, well written, and merges theory and practice into useful
therapeutic suggestions, making it a text that should be required reading for practicing neurologists.
Bradley S. Galer, MD
Seattle, WA
Resolving Ethical Dilemmas: A Guide for Clinicians
By Bernard Lo, MD
Baltimore, Williams & Wilkins, 1995
373pp, $3695
Ethical problems occur so frequently in neurology that one
might consider including a course in medical ethics in every
residency training program. At the very least, residents (and
practicing neurologists) should be encouraged to read this
new, highly practical book on how to deal with the common
ethical problems that arise in medical practice.
This book is a real gem! The writing is plain and easy to
understand, the subject matter is fascinating, and the author
is eminently fair in presenting arguments for and against
various courses of action. The principles of medical ethics
are developed in a lucid, orderly fashion, frequently illustrated by brief clinical vignettes. Legal aspects are given full
consideration and are carefully distinguished from ethical
reasoning.
Neurologists will find especially useful the discussions of
medical futility; when life-saving interventions can be withheld; how to deal with patients who lack decision-making
capacity; and legal problems raised by brain death and the
vegetative state. The rights of physicians to refuse care, and
other disturbances of the doctor-patient relationship, are explained at length.
The author’s background as a general internist is evident
in his sympathy for the feelings of both patients and physicians in stressful circumstances. N o other textbook of medical ethics is as relevant to everyday clinical practice or as
useful to physicians. This book should be in every neurologist’s library.
Robert B. Layzer, MD
San Francisco, CA
Brain Mapping The Methods
Edited by Arthur W Toga and John C. Mazziotta
San Diego, CA, Academic Press, 1996
471 pp, illustrated, $145.00
This timely and authoritative textbook brings together a wide
variety of both basic and clinical brain mapping methods.
Drs Toga and Mazziotta are recognized experts in the field
and have accomplished this difficult task admirably. The finished work reflects the considerable basic science and clinical
talents of the multiple contributing authors.
The book is organized into 18 chapters comprising six
sections. An introduction is followed by two chapters on
optical tracer methods, spanning both microscopic and in
vivo work. An excellent summary of local cerebral blood flow
methods collected from rodent studies follows, and then an
overview of quantitative autoradiographic methods is presented. The next four chapters summarize magnetic resonance imaging (MRI), postmortem anatomy, and positron
emission tomography. This includes a well-written chapter
on functional MRI applications, provided by D r Mark Cohen. An overview of electroencephalogram-based brain mapping is provided by Alan Gevins, and motor and sensory
mapping is outlined by Dr Paul Cheney.
The statistical treatment of mapping methods is next covered in three chapters. Multimodality image registration topics are reviewed by D r Roger Woods and statistical parametric mapping by D r Karl Friston. An overview of approaches
to quantifying human neuroanatomical variability is also included. The final section consists of discussions of the importance of time and space in brain mapping, three-dimensional
volumetric techniques, and speculations about future developments in brain mapping.
This widely ranging work spans both basic research applications and more clinically directed human studies. The
book certainly provides excellent treatment in the areas described above, particularly in the basic sciences. O n the clini-
Annals of Neurology Vol 40
No 5
November 1996 823
cal side, I would like to have seen more on intraoperative
techniques used in neurosurgery, in the area of high-resolution MRI, and in niagnetoencephalography. There was also
considerable redundancy in the basic physics sections between the two MRI chapters, which might be tightened up
in future editions.
Overall, this multiauthored book is very well written and
beautifully illustrated. Generous use of color figures and
excellent line diagrams complement the text. The table of
contents is listed in outline form, providing a handy navigational aid. The index, while somewhat terse, is useful and
accurate.
Brain Mapping: The Method- is a timely and important
source book for learning more about the tools used to relate
brain structure and function. This new reference work will
rightfully find its place in the libraries of both research scientists and clinicians in the neurosciences.
Howrrrd A. Rou~hy,MD
San Frtlncisco, C.2
Neurologic Rehabilitation: Contemporary Neurology
Series, Vol 47
By Bruce H. Dobkin
Philadelphia, FA Davis, 1996
338 pp, illustrrrced, $93.00
Neurorehabilitation continues to attract attention from neurologists, as advances in functional neuroimaging and understanding of neuroplasticity offer new hope for reversal of
neurologic impairment and disability. The growth in clinical
interest may be attested to by the appearance of an increasing
number of books on the subject. Dobkin has now provided
us with a fine effort in the best tradition of the FA Davis
Contemporary Neurology Series.
The text is roughly divided into the following four sections: scientific basis of functional recovery in the nervous
system; the organization of rehabilitation teams and how to
measure what they do; commonly encountered medical
problems in neurologic rehabilitation; and specific restorative
management of neurologic disorders, principally stroke, traumatic brain injury, and spinal cord injury. Neuromuscular
disease and peripheral nervous system issues are given relatively little attention. Detailed reviews of topics such as orthotics, assistive technology, or psychosocial issues in rehabilitation are omitted, but all important areas are touched upon
in an integrated and readable format. Handy tables and illustrations are ample and the bibliography is up to date.
Neurologic Rehabilitation is clearly distinguished from
other books on the subject by being single authored. Dobkin
has a healthy skepticism about traditional rehabilitation
dogma and is quick to point out the gaps i n scientific validation of various approaches and techniques. H e presents a
view of neurorehabilitation from the vantage point of an
experienced clinical scientist and practitioner, summarizing
the excitement and limitations that neurologists may find
within the field. As with most titles in this series, the volume
is well produced and will be useful for clinicians at all stages
of training, from niedical student to chief of service. Priced
at under $100.00, it should be a cost-effective addition to
824
Annals of Neurology
Vol 40
No 5
November 1396
the library of anyone interested in a thoughtful approach to
the management of disabling neurologic disorders.
Gary M . Abrams, M D
San Franrisro, CA
Books Received
Pediatric Clinical Electromyography
By H. Royden Jones, /r, Charles F. Bolton, and
Harper, Jr
Philadelphia, Lippincott-Raven, 1995
487 pp, illustrated, $98.00
(3.
Mirhael
Manual of Stroke Rehabilitation
By Karl J. Srrndin and Kristin D. Mason
Boston, Butterworth-Heinemann, 1996
194 pp. illustrated, $40.00
Topical Neurology
Edited by Raad A. Sbakir, Peter K Newman, and Charles
M. Poser
London, W B Saunders, 1996
485 pp, illustrated, $75.00
Brain Injury and Pediatric Cardiac Surgery
By Richard A. Jonas, Jane W Newburger, rrndjoseph J
Volpe
Boston, Butterworth-Heinemam, 1996
416 pp. illuscrated, $1 25.00
Principles of Spinal Surgery, Vols I and I1
Edited by Arnold H. Menezes and Volker K H . Sonntag
New York, McGraw-Hill, 1996
1,525 pp, illustrrrted, $295.00
Evaluating Sleep in Infants and Children
By Stephen H. Sheldon
Pbilade&hirr, Lippincott-Raven, 1996
276 pp, illustrated
Office Practice of Neurology
Edited by Martin A. Samuels and Steven Feske
New York, Chirrrbill Livingstone, I996
1,280 pp, illustrated
Essentials of Clinical Neurology, ed 3
By Leon A. Weisberg, Carlos Garria, and Richard Strub
St. Louis, Mosby, 1996
786 pp, illustrated
When the Air Hits Your Brain
By Frank T.Vertosick,Jr
New York, WW Norton, 1996
268 pp, $23.00
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diego, 1996, 471, arthur, mazziotti, method, illustratred, brain, toga, academic, john, 145, mapping, san, pres
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