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Current topics in nerve and muscle research (excerpta medica international congress series no. 455) . Edited by Albert J. Aguayo and George Karpati excerpta medica amsterdam and oxford 1979 $58

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BOOKS
Reviews
C u r r e n t Topics in N e r v e and Muscle Research
(Excerpta Medica International Congress Series
No. 455)
Edited by Albert J . Aguayo and George Karpati
Excerpta Medica, Amsterdam and Oxford, 1979
$%SO
This volume contains papers selected for the symposia at
the Fourth International Congress on Neuromuscular Diseases, held in Montreal in September, 1978. Since the
symposia were arranged by the organizing committee, the
book inevitably reflects that committee’s perception of
what topics are of major interest in neuromuscular disease.
Separate sections deal with the muscle cell membrane,
muscle metabolism, myasthenia gravis, developmental
muscle disorders, nerve structure and function, cellular
interactions in the peripheral nervous system, and metabolic and toxic neuropathies.
The papers from the first symposium deal with the
currently favored theory of muscular dystrophy, which
postulates that the basic abnormality resides in the membranous components of the muscle fiber. However, a
number of membrane abnormalities which have been observed in erythrocytes in patients with Duchenne dystrophy are difficult to reproduce. A large array of possible
biochemical and morphological disturbances have been described, but i t is unclear which of these, if any, represents a
primary abnormality.
Three important regulators of muscle metabolism and
function-cyclic
nucleotides, thyroid hormones, and
calcium-are considered in excellent presentations. The
papers dealing with the acetylcholine receptor and myasthenia gravis summarize the exciting and important developments in this field since 1975. They review the evidence
that acquired myasthenia gravis is an autoimmune disorder
which causes a deficiency of the nicotinic postsynaptic
acetylcholine receptor. However, what instigates and perpetuates the immune response is still mysterious. Additional papers concerning muscle describe the advantages
which can be gained from studying muscle cells in culture,
and there are two lucid and critical surveys of congenital
neuromuscular diseases.
The papers dealing with nerve structure, function, interactions, metabolism, and response to toxins, all outstanding, describe how electrophysiological, cytochemical,
and freeze-fracture electron microscopic methods have
been used to their full advantage. The final section is a nice
summary of current knowledge about toxic neuropathies.
This short volume presents a fine overview of current
topics in neuromuscular disease. I recommend it highly to
clinical neurologists and investigators.
Andrew G. Engel, M D
Department of Neurology
Mayo Clinic
Rochester, MN 55901
C u r r e n t Practice of Clinical Electroencephalography
Edited by Donald W . Klass and D a d D. Dajy
Raven Press, New York, 1979
532 pp, illustrated, $45.00
Drs Klass, Daly, and their associates have written a lucid,
well-illustrated text for neurologists and general physicians
who desire to learn the essentials of electroencephalography. There are chapters about the physiological basis of
EEG activity, basic electrical principles that underlie the
use and interpretation of appropriate montages, technical
pitfalls of recording electrical potentials from the scalp, and
artifacts. There are several chapters on the normal EEG
during development. The section about the EEG in the
neonatal period is presented too briefly, but it still provides
an excellent basis for further reading. The chapter on normal development during childhood and adult life, which
emphasizes permissible variations, is an example of how to
present a massive amount of information in a spare and
logical framework. Other chapters o n EEG patterns seen in
epilepsy and following focal and diffuse insults to the brain
..
are also well written.
This book is not a monograph; it d.oes not evaluate the
use of EEG in all disease states, nor does it present controversial issues in detail, although in most instances it labels such issues appropriately. For interested readers, an
informative series of discussions in the appendix outline
some problems of recording and interpreting the EEG in
greater detail.
N o r can this book be used as part of a self-instruction
program. There is a wealth of information, often closely
integrated with accompanying illustrations, but it is presented concisely and almost epigrammatically in some
chapters. The book is meant co be used as an accompaniment to a teaching program or as a brief review for someone who is already trained in the essentials of EEG. I t
fulfills these purposes admirably.
Criticisms are minor if one appreciates the audience to
which the book is directed. Nasopharyngeal leads are given
almost no space in the text, although they are a frequently
used recording technique. Little information is provided
about the uses and hazards of telemeterized EEG o r longterm recordings. Some space is given to computer interpretation of EEG data, but the practical uses of these
methods and the controversial results obtained by spectral
analysis are not covered in detail. The most serious defect
in the book is the editors’ propensity to put chapters out of
sequence. Principles of localization are discussed in Chapter 3, while closely related topics in neurophysiology are
not approached until Chapter 15. Similarly, technical
problems in recording and interpreting the EEG are scattered throughout the book.
Despite these minor criticisms, the book is a major contribution to the training of neurologists in electroencephalography. It is one of the few textual sources that tries
to state clearly the value and limits of the EEG in an era of
highly sophisticated radiological techniques for localization
of brain lesions. It is recommended for all but the most
sophisticated electroencephalographers.
Arthur L. Prensky, M D
Department of Pediatrics
St. Louis Children’s Hospital
500 S. Kingshighway Blcd
St. Louis, MO 631 10
206
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