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Show Book Review Neuro-opthalmology Now! Edited by J. Lawton Smith, M. D. NCIl' York: ridd, [\iC/, II/,eI A~~o(illlc ..;, [IIC. 19S(1, $6Y.LJ5. JHlJ pp. (Distributed by Year Bt)t)K rvkdical Publishers, J5 E. Wackl'r Dr., Chicagll, IL bObOI.) This bt)oK Cllmprisl:'s 35 chapters written by 64 contributors. Manv of them are fllrmer trainees of Dr. J. Lawton Smith and all are contemporary experts in their respective fields, including senior authors such as David G. Cogan, Alfred Huber, and Thomas J. Walsh. Smith himself presents 50 "pearls" of practical clinic points in neuro-ophthalmology in the first chapter and is a coauthor of four others in this collection. Most chapters describe small series or single case reports of noteworthy subjects in the field. Two papers discuss echography and emphasize A-scan techniques for orbital scans, a new favorite of Smith's. Unfortunately, the interpretation of such scans requires a lot of experience and second guessing on the part of the examiner and necessitates a dynamic aspect that does not lend itself well to illustrations. Despite the editor's enthusiasm, A-scans are not likely to be widely applied. A chapter on testing methods in cases of hereditary retinal degenerations is useful as a review of electrodiagnostic procedures. The article that addresses hormone-secreting pituitary tumors is timely and loaded with new "pearls." The uses and limitations of digital subtraction angiography are outlined with several good illustrations. Drs. Huber and Yasargil have contributed a beautifully illustrated and well-written chapter on ophthalmic artery aneurysms. They describe interventional neuroradiology for carotid-cavernous fistulas as an alternative treatment for an otherwise very difficult-to-treat disease, and admonish us to await resolution in spontaneous fistulaswhich is good advice. A short chapter on myasthenia gravis emphasizes that the presence of an "anterior junction line" on chest films and a negative antistriational antibody titer rule out a thymus tumor. Disturbances of fixation from microdrift tll macrosaccadic oscillations are discussed in another chapter, and Smith interjects a bit of the clinician's perspective for bedside diagnosis. "j 1986 Raven Press, New York The problem of migraine is exhaustively treated in a chapter that includes an addendum by Smith. Syphilis, one of Smith's favorite topics, is covered in another well-illustrated selection. Increasing numbers of new cases, some with resistance to penicillin, have given rise to not a little anxiety. Three-dimensional computed tomographic scanning is discussed in a paper on congenital malformations; the text implies a significant potential for reconstructive surgery based on bony images analyzed with three-dimensional imaging. One chapter emphasizes that Wernicke's encephalopathy is not uncommon. The descriptions of clinical features and some neuropathologic features are helpful for understanding the diverse manifestations of this deficiency state. It is found not only in alcoholics, but also in nonalcoholic conditi~ns, which are listed. One notable cause is surgical treatment for obesit~·. Some recent evidence links a genetic predisposition by a reduced enzymatic affinity for thiamine in some patients. New radiologic techniques are described in a chapter emphasizing magnetic resonance imaging for conditions such as demyelinating disorders, small cysts, and the empty sella syndrome. For some reason a paper on d~'stonia and spasticity is included-perhaps to distinguish it from ocularinduced torticollis. Hypertension is the topic of another chapter. which reminds us that we are physicians and that our patients have to be regarded as more than just a platform for the visual system. The book concludes with an update on the acquired immune deficiency syndrome which is well illustrated with clinical and 'ocular findings. Overall this book is worthy of praise and deserves a place in the libraries of ophthalmologists and neurologists, and particularly of students of these specialties. As a practicing neuro-ophthalmologist, 1 learned from it and commend it. Brian R. Younge, M.D. Department of Ophthalmology Mayo Clinic and Mayo Foundation Rochester, MN 55905 268 |
