Clinical neuropharmacology, vol. 2

Clinical neuropharmacology, vol. 2

Journal of the Neurological Sciences, 1978, 38:441-442 © Elsevier/North-Holland Biomedical Press 441 Book Reviews Clinical Neuropharmacology, Vol. ...

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Journal of the Neurological Sciences, 1978, 38:441-442 © Elsevier/North-Holland Biomedical Press


Book Reviews

Clinical Neuropharmacology, Vol. 2, by H. L. Klawans, (Ed), x + 208 pages, I illustration, 17 tables, Raven Press, New York, 1977, US$ 22.50. In this second volume the editor has assembled a distinguished band of contributors who write on remarkably diverse topics. W. J. Weiner and D o n n a Bergen discuss a topic of great importance to all practising neurologists, the management of the side effects of levodopa therapy. Unfortunately, but in the present state of knowledge, predictably, they find themselves unable to formulate a rational method of controlling the on-off effect, now such a prominent feature in severe Parkinson's disease. The chapter is, however, full of useful practical advice on other aspects, based on personal observation and coverage of the literature. The chapters on the pharmacology of dystonia and the treatment of MS are naturally less informative because both present, in their different ways, intractable and ill-understood problems. Charlene Moskovitz and the Editor write well on the important topic of the affective disorders. V. P. Zarcone's chapter on sleep disorders is too brief for full exposition of this expanding subject and this reviewer did not feel fully competent to diagnose the neutral point syndrome or the sub-wakefulness syndrome after reading the abbreviated descriptions. The chapter on tuberculous and fungal meningitis gives a good account of the treatment of these conditions, particularly the former. Dr. Yatsu has another thankless task describing the therapy of acute stroke where, despite great advances in knowledge, treatment appears to be without influence on the outcome. The chapter on hepatolenticular degeneration, no doubt because of an editorial decision, refers to "Wilson disease" matched by " H u n t i n g t o n " chorea elsewhere in the volume, harmless but somewhat jarring abbreviations. Somewhat aside from these practical clinical considerations is a most interesting chapter on the cocaine-kindling model of psychosis by R. M. Post. This volume contains much of interest but, as in all multi-author books, there is much variation in the depth to which different subjects are discussed. W. B. Matthews

Persistent Pain - - Modern Methods of Treatment, Vol. 1, by S. Lipton (Ed.), ix + 272

pages, 65 illustrations, 8 tables, Academic Press, London and Grune and Stratton, New York, 1977, £ 10.50, US$ 20.50. This is the first of two volumes on this important topic and is largely based on the experience in the pain relief clinic in Liverpool where the Editor has pioneered or developed a number of the techniques described. The chapter by David Bowsher on the anatomo-physiology of pain is of great interest but it is disappointing that he was not able to link his account with recent knowledge of encephalins. It is surprising how many aspects of prolonged intractable pain remain unexplained except by a postulated "changed central state". Percutaneous cordotomy by the lateral approach is described by E. Ganz and S. Mullah and is plainly an effective technique in skilled hands. It is a pleasure to see R. Maher's pioneer work on intrathecal phenol acknowledged by his contribution to the chapter on spinal and epidural analgesia. Felix M a n n ' s chapter on acupuncture does not present a convincing case for the use of this technique in the relief of pain which he regards as mainly a secondary effect of the cure by this means of the underlying disease. The reader will sense a lack of controlled observation. Methods of stimulation in the attempted relief of pain ranging from the peripheral nerve, via the dorsal columns to the thalamus are described by J. P. Miles, but more explicit information on the indications for these methods and the results to be expected would have been welcome. Much of the rest of