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Clinical neurophysiology of the vestibular system (contemporary neurology series vol 18) By R. W. Baloh and V. Honrubia F. A. Davis Company Philadelphia 1979 230 pp illustrated $30

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chapters o n neuron identification by transmitter histochemistry and environmental determinants of transmitter
synthetic pathways are succinctly written and wellreferenced reviews. The articles o n regulation of acetylcholine receptors and formation of neuromuscular
synapses are cogent and systematic presentations which
effectively relate specific research findings to fundamental
questions in neurobiology.
One drawback is the length of time between the symposium and publication of this volume. In some cases, the
data have already been published elsewhere.
James C . Blosser, PhD
Department of Neurology
Baylor College of Medicine
Houston, T X 77030
Proceedings of the Second World Congress on Pain
(Advances i n Pain Research and T h e r a p y , V o l 3 )
Edited by John J . Bonica,John C . Liebeskind,
and Denise G . Albe-Fessard
Raven Press, New York, I979
$75.00
This volume contains ninety papers selected from the hundreds presented at the Second World Congress o n Pain
held in 1978. Most interesting is the overview it presents of
work being done in the field of pain. From this book one
can acquire a large amount of information concerning the
anatomy and physiology of neurons and circuits activated
by noxious stimuli, the abnormalities exhibited by some of
these neurons in experimental and clinical painful states,
the effects of stimulation of various structures on the
transmission of nociceptive information, the measurement
of pain, the endorphins, and the clinical manifestations of
several important painful conditions. However, since many
of the communications are terse, consist of reports of research heretofore unpublished (and incidentally, unreviewed), and often assume a working knowledge of
anatomy or physiology o r neurosurgery, this collection of
papers can best be understood by those already conversant
with the field. It is not a book to be read lightly by the
practicing neurologist in search of a comprehensive scheme
for managing patients suffering from pain.
As in all such collections, a few papers stand out-in this
case offering evidence of the amazing distance the field has
progressed since Melzack and Wall advanced their catalytic
gate hypothesis in 1965. Particularly impressive contributions in this regard are the papers by Zimmerman (spinal
and peripheral mechanisms involved in nociception), Wall
(changes in damaged nerves and their sensory consequences), Gobel (neural circuitry in the substantia
gelatinosa), Mayer (endogenous analgesia systems), Fields
and Basbaum (descending pain control systems), Andersson (pain control by sensory stimulation), Howe
(mechanisms of radicular pain produced by root compression), and Bonica (causalgia). Most of these papers are reviews of recent work o r combinations of new observations
with summaries of previous knowledge.
As expected in a book of this type, there is no unifying
theme beyond the subject of the conference. However, the
108 Annals of Neurology
Vol 10 No 1 July 1981
editors have attempted to keep the treatment balanced.
And while there is not a synthesis of existing ideas, the review papers d o put things in perspective. In addition, the
book serves two very useful purposes: it provides one with
a feeling for the “state of the art” and acts as a stimulus for
further research.
Robert A . Dauidoff, M . D .
Depurtment of Neurology ( 0 4 - 5 )
University of Miami
School of Medicine
PO Box 01 6960
Miami, FL 33101
Clinical Neurophysiology of the Vestibular System
(Contemporary Neurology Series, Vol 18)
By R. W . Baloh and V . Honrubia
F . A . Davis Company, Philadelphia, 1979
230 pp, iliustrated, $30.00
This superb text by a neurologist and an otolaryngologist
successfully fills a gap in the neurological literature and
presents a clear exposition of the basic physiology and
clinical disorders of the vestibular system. The authors first
give a detailed review of the anatomy, phylogeny, and
physiology of vestibular function. The introductory chapter
is followed by review of the peripheral and central vestibular systems. These sections are well illustrated and include modern concepts of function of the vestibular end
organ and known anatomy of the central vestibular pathways. The reader is carefully guided through mathematical
concepts of vestibular physiology, anatomical control of
eye movements, and complexities of visual-vestibular interactions.
T h e authors’ approach to clinical evaluation of the vestibular system, including a brief review of nystagmus, is
presented in the fourth chapter. Since electronystagmography is one of the major diagnostic techniques
for evaluation of the vestibular system, a full chapter is
devoted to this technique of eye movement recording
and its interpretation. The only section that is, unfortunately, too brief is that on clinical evaluation of hearing,
with just a passing review of audiometry and a brief paragraph on auditory evoked potentials. This would have been
an ideal opportunity to review information that is difficult
for neurologists to obtain in an understandable format. The
final section, on differential diagnosis of vestibular system
disease, includes descriptions of most known disorders
producing vertigo and dizziness.
The entire text contains appropriate, up-to-date references and is very readable. Clinical Neurophysiology of the
Vestibular System is a major and most affordable text which
I would strongly recommend as a purchase for all
neurologists dealing with patients who experience dizziness
as well as those who want an up-to-date review of the neurophysiology of vestibular function.
8. Todd Troost, M D
Veterans Administration Medical Center
Wade Park
Cleveland, OH 44106
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1979, series, illustrated, neurology, neurophysiology, baloh, honrubia, system, company, philadelphia, 230, clinical, vestibular, david, vol, contemporary
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