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Focal peripheral neuropathies second edition. By John D. Stewart MB BS FRCP(C) New York Raven Press 1993 506 pp illustrated $85

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Edited by PeterJ. Whitehouje
Contemporay Neurology Series
Philndelphiu, FA Ddvis, 1993
465 pp. illustrated
This mo‘nograph strikes a reasonable balance in covering the
challenges of dementia-biological, psychological, and societal. Thirty-three contributors have written 15 chapters and
an epilogue. Part I deals with approaches to the study of
dementia: epidemiology, genetics, neurobiology, clinical
evaluation, and neuropsychological assessment. Part II contains chapters on the major disease categories causing dementia. Part 111 addresses the management and treatment of patients with dementia, with the last chapter focusing on legal
and financial decision-making. The chapters range in quality
from good to excellent and all are highly structured to be
informative and readable. The widespread use of tables enhances the quality of the material presented. The text is well
referenced, sometimes to an encyclopedic degree, e.g., 3-18
references for neurobiology and 364 references for the degenerative dementias.
For this reader, the highlight chapters were those on genetics, clinical evaluation, neuropsychological assessment, cognitive impairment in the psychiatric syndromes, and metabolic
dementias (even though this chapter referred the reader excessivcly to the 1983 monograph on dementia by Cummings
and Benson). My only major disappointment was the contribution on vascular dementias. It reads as though it were written in 1985, even though there are four references to papers
dated 1987 (the most recent citations).
Spelling, typographical, and factual errors are rare. For instance, in the discussion of neuroimaging in normal pressure
hydrocephalus, one finds that “the temporal horns are 2 mm
or greater in width.” I was surprised to see the Guamanian
neurological disease complex ascribed (chapter on degenerative dementias) to ingestion of the betel nut instead of cycad
bean constituents. The same chapter cites the 1991 paper on
a reportedly successful replication of the histological feature.
of Alzheimer’s disease (AD) in a transgenic mouse, a report
that was discredited within a few months. It was also disappointing to read in the same chapter that “a few of these
conditions ;ve treatable,” a common but regrettable tendency
to label A D “untreatable.” Even though one can argue on an
intellectual level that current treatment strategies for A D
don’t treat the underlying disease, many published articles
and monographs, including this one, address therapeutic
strategies in dealing with AD. The chapter o n management
is too short for 1993. It emphasizes interdisciplinary strategies but offers only one paragraph referring to “new respite
and residential-care programs,” something that might now be
called “specialized dementia care.”
Overall, editor Whitehouse’s product ranks well up there
among the spate of entries in the dementia derby.
Focal Peripheral Neuropathies, Second Edition
By-John D. Stewart. illB. BS. FRCPICI
Nrw York. Raven Preu. 1993
506 pp, zllustmted. $SS.00
Focal peripheral neuropathies are among the most common
disorders encountered in clinical practice, yet their recognition may be difficult and their treatment challenging and controversial.
Dr Stewart, however, is successful in covering all the information needed to diagnose and manage these conditions. He
is like an erudite guide taking his armchair travelers along
the “precarious course” of the peripheral nerves as they wend
their way from the spinal cord to their nerve terminals. He
covers the terrain in a concise but comprehensive fashion.
Most of the book is devoted to a thorough discussion of
the disorders affecting nerve roots, plexuses, and individual
peripheral nerves. In the first five chapters of the book however, D r Stewart reviews aspects of basic science pertinent
to the understanding of peripheral nerve disorders including
histology, anatomy, and neurophysiology. In another chapter
he takes us to the bedside to emphasize important aspects
of history-taking and physical examination.
There are many excellent tables, figures, radiographs, and
some photomicrographs. There is an extensive bibliography,
especially impressive because the papers cited come from a
wide variety of disciplines including the basic sciences, orthopedics, plastic surgery, neurosurgery, internal medicine, and
In summary, this informative book is a pleasure to read.
It should be useful to anyone with an interest in the diagnosis
and therapy of peripheral nerve disorders. Seasoned clinicians will turn to it for guidance when they are faced with a
perplexing focal neuropathy and it should have a strong appeal to residents and fellows, who will find D r Stewart an
excellent teacher.
David A. Chad, M D
Worce.rter,M A
On page 81 of the January issue, in the article by Lippa
and colleagues (Lippa CF, Smith TW, Swearer JM. Altheimer’s disease and Lewy body disease: a comparative
clinicopathological study. Ann Neurol 1994;35:8188), the neurites in Lewy body disease were incorrectly
described as tau positiuelubiquitin negative. The correct
description is tau negativelubiquitin positizv neurites.
Leonuvd Bwg
St Louts. M O
380 Copyright 0 1994 by the American Neurological Association
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second, periphery, illustrated, 506, new, john, neuropathic, edition, stewart, frcp, 1993, york, focal, rave, pres
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