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Guillain Barr syndrome. By Richard A. C. Hughes MD New York Springer-Verlag I990 308 pp illustrated $ 142

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the human species acquired an infinitely expandable, extracorporeal memory. Advance was no longer contingent on a
few wise men with phenomenal memories and communicative skills. Even those of modest talent could access vast libraries that contained the distilled wisdom of all humanity.
The discovery of language, and especially of writing, enabled
great cognitive leaps to occur without comparable changes in
the underlying biological hardware.
This is a complex book. Some parts are excellent. Others,
especially those related to the brain, can stand improvement.
I hope this can be achieved at a subsequent edition. In the
meantime, those of us who can step back from the daily
routine of tapping tendons and wonder about the mysterious
neurological foundations of human cognitive evolution will
find this book stimulating.
Marsel Mesulam, MD
Vertigo: Its Multisensory Syndromes
By Thomas Brandt
London, Springer-Verlag, I991
329 pp, illustrated, $89.00
Vertigo distinguishes itself by being a single-authored book
about a field that crosses the boundaries of several specialties,
including neurology, otolaryngology, ophthalmology, and
psychiatry. The author is one of a few neurologists who have
endeavored to bring the subject of dizziness and disequilibrium to light in the neurology community. Unlike other
texts that treat this subject, the work is unique in that it
focuses neither upon the vestibular system per se nor upon
motor manifestations of imbalance; rather, the text uses the
symptom of vertigo as its point of departure into an in-depth
treatment of various conditions that cause alterations in spatial orientation.
The reader is given a somewhat private view into how a
preeminent neurologist thinks about patients with vertigo.
The author combines his own opinions with ideas drawn
from an extensively though not exhaustively cited literature.
Historical perspectives often introduce topics with new and
insightful observations enmeshed in discussion material. Although the opinions of the author are unmistakable, several
topics are appropriately portrayed as controversial, such as
disabling positional vertigo and horizontal semicircular canal
benign paroxysmal positional vertigo.
The organization of the book is contrived to include under
one cover material that might otherwise not seem related,
e.g., perilymphatic fistula and acrophobia. The text begins
with a brief introduction that contains a valuable discussion
of physical therapy for balance disorders. The body of the
text is contained in ten sections of various lengths that pertain
to peripheral vestibular disorders, central vestibular disorders, positional vertigo, vascular vertigo, traumatic vertigo,
familial and childhood vertigo, drugs and vertigo, nonvestibular vertigo, psychogenic vertigo, and physiological vertigo.
Thus, some sections are based upon symptoms, some upon
signs, some localization, and others etiology. Despite extensive cross-referencing, this method of organization may be
confusing to persons new to this already complex field.
In summary, Vertigo is a treatise worthy of a place on the
bookshelf of any neurologist who is confronted by patients
with dizziness.
Joseph M. R. Furmun, MD, PhD
Guillain Barre Syndrome
By Richard A. C. Hughes, MD
New York, Springer-Verlag, I990
308 pp, illustrated, $ I 42.00
Guillain Barre Syndrome
By Allan H. Ropper, MD, Eelco F . M . Wijdickr, MD, and
Bradley T . Truax, MD
Philadelphia, F. A. Davis, 1991
369 pp, illustrated, $70.00
Guillain Bard syndrome (GBS) has been a favorite subject
for European doctoral (MD) theses in the past 25 years, and
has also been reviewed in two supplements of this journal in
1981 and in 1990. Now, in the past year, two authoritative
monographs on GBS have appeared, each by a single author
or group of authors.
Ropper, Wijdicks and Truax, citing the large and wellcharacterized experience at the Massachusetts General Hospital, concentrate on the clinical phenomenology and management of GBS. At the same time, they give a workmanlike
and balanced account of the immunological basis and current
research. In contrast, Hughes utilizes his extensive experience with the experimental immunobiology of the peripheral
nervous system and experimental allergic neuritis to consider
GBS as an immunopathy. He also covers the clinical and
laboratory aspects in a satisfying way, although not in quite
the detail of Ropper and colleagues. Hughes also includes a
chapter on chronic inflammatory demyelinating polyneuropathy, which summarizes concisely that complicated subject.
These two monographs are remarkably complementary and
taken together provide a thorough and convincing account
of our knowledge of GBS.
A . K . Asbury, MD
Sensory Mechanisms of the Spinal Cord, ed 2
By William D . Willis,Jr, and Richard E. Coggeshall
New York, Plenum Publishing, I991
575 pp, illustrated, $89.50
The first edition of Sensory Mechanisms of the Spinal Cord
provided an overview of the spinal mechanisms of somatosensation, beginning with some general issues of sensory coding, then discussing peripheral nerves and receptors, and the
organization of the dorsal horn and ascending tracts. This
new edition maintains the same general framework but has
been expanded considerably to provide an up-to-date and
comprehensive reference to current knowledge of the peripheral and spinal mechanisms of somatosensation. The new
coverage of the chemical neuroanatomy of primary afferents
and dorsal horn neurons, and of the neuropharmacology of
the dorsal horn, is particularly noteworthy, as is the final
Annals of Neurology Vol 32 No 4 October 1992 601
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