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Show BOOK REVIEWS Section Editor: Barrett Katz, MD, MBA The Neurology of Vision Jonathan D. Trobe, MD. Oxford University Press, New York, NY, 2001. ISBN: 0195129784, Order No.: 800- 451- 7556, Price: $ 120.00 Scope: This is a carefully compounded and well referenced text that describes in detail the anatomy, physiology, and function of the optical, retinocortical, and integrative components of the human visual system. The book is Volume 60 in the Contemporary Neurology series, which is intended for neurologists, but the material is equally relevant for ophthalmologists. In fact, some sections are more ophthalmologically than neurologi-cally oriented and provide a quick eye reference for neurology types. The author is a rare bird, board- certified in both neurology and ophthalmology, and uniquely qualified to add a thorough review of disorders of visual perception for the renowned Contemporary Neurology series. Dr. Trobe is a coauthor of the largely algorithmic Clinical Decisions in Neuro- Ophthalmology, but he has now turned to the more familiar topical discussion formula; his discussions are very complete, indeed. Contents: The section on the afferent system alone runs to more than 400 pages and encompasses six areas that include: " How the Human Visual System Works," " Symptoms of a Failing Visual System," " Measures of a Failing Visual System," " Topographic Disorders," " Nonorganic Visual Disturbances," and a final section of " Problem Cases: Questions and Answers." There are 18 Chapters, ranging in topics from a primer on optics, discolored images, provoked transient visual deficits, failed recognition, visual field interpretation, electrophysiologic evaluation of visual loss, retinal and choroidal vascular disease, and toxic retinopathies. Especially noteworthy is the material related to posterior visual pathways and cortical and visual integrative functions. The diagrammatic illustrations of Tanya Leonello will be an aid for all. The abundant use of tables, carefully considered clinical illustrations, and reproductions of neuro-images are highlights that add further value to this new text. The section on " Problem Cases: Questions and Answers" is an innovative and highly instructional exercise. It is difficult to write multiple- choice questions, and some reader dissension is a likely, if not anticipated, response. Nonetheless, ample discussion of the answer choices is provided, and serves as a remarkable learning device perfect for group discussions of residents in training. There are some minor problems. For example, in Question 6, a 20- year- old girl has, among other findings, ' subtle optic disc edema,' but the answer given is ' bilateral retrobulbar neuritis'. Hmmm. Strengths: The material is very balanced, up- to- date, and meticulously illustrated. I predict that many of the illustrations will show up purloined in future basic lectures of Dr. Trobe's colleagues! That is a compliment. The text is reader- friendly, and the writing style at times verges on conversational ( will all readers know what " white coat" hypertension is?). The sixty color fundus photos are carefully selected and of excellent quality. In Chapter 7: " Visual Fields," the author suggests that field testing " remains deeply flawed, and is rarely used properly." " Testing is long and boring... results are difficult to interpret..." and that computerized methods " generate a lot of confounding psychophysical ' noise'." This said, the reader will find the phenomenon of visual fields fully treated: the relevant section forms an excellent fields primer. The index is very thorough, though I suspect not of the author's construction. Who will look under, for example, ' Aging persons,' ' Boys,' ' Cocktail party,' ' Girls. See Females' [ do, by all means], ' Gotcha,' ' Lorenzo's oil,' ' Pizza- pie retinopathy,' and other all- inclusive victimizations of the author's sensibilities by a distant publishing house indexer? Weaknesses: Many of the ocular diagrams ( i. e., refractive conditions, vitreal disorders, aqueous dynamics in glaucoma), some photos ( a bottle of phenylephrine) seem to occupy space unnecessary for ophthalmologists, but perhaps interesting for neurologists. The extraneous items included in the index notwithstanding, it is better to " over- index" than to " under- index". Recommended audience: This text will serve well the needs of trainees in neurology and ophthalmology and even medical students. For the former, there is sufficient ophthalmologic material that provides an adequate basic background. For both graduate disciplines, disorders of the afferent visual system are thoroughly covered. The teaching-learning value of the final section, " Problem Cases," is again worth noting. Critical appraisal: Altogether a useful, well integrated, cleverly conceived, fully illustrated, and admirable opus from an innovative and skilled educator. Joel S. Glaser, MD Bascom Palmer Eye Institute University of Miami Miami, FL ^ 146. pOL10.1097/ 01. WNO, 0.0Q0018262.8,7375.], 0 JNeuro- Ophthalmol. Vol. 22, No. 2,2Q02 , Copyright © Lip pincott Williams & Wilkins. Unauthorized reproduction oftnis article is prohibited. BOOK REVIEWS JNeuro- Ophthalmol, Vol. 22, No. 2, 2002 Neuro- Ophthalmology: Section 5, Basic and Clinical Science Course The Foundation of the American Academy of Ophthalmology, San Francisco, CA, 2002. ISBN: 1560552182, Order No.: 415- 561- 8540, Price: $ 90.00 for nonmembers, $ 60.00 formembers; Series price: $ 895.00 for nonmembers, $ 595.00 for members Scope: This volume is part of the recently revised edition of the Academy' s Basic and Clinical Science Course designed for residents in ophthalmology. It is a multiauthored, paperback, self- contained practical overview of clinical neuro-ophthalmology that is supposed to encompass all the clinical neuro- ophthalmology an ophthalmology resident needs to know. Contents: This volume is creatively organized in a symptom- driven approach, designed to focus on how the practicing clinician deals with neuro- ophthalmic signs and symptoms. The authors have attempted to highlight with brief description the more common entities seen in neuro- ophthalmic practice. Emphasis is placed upon the examination and the appropriate use of adjunct testing. The text is readable, clinically relevant, and non-threateningly presented. The first chapter describes the relevant anatomy that is the framework upon which neuro- ophthalmic understanding is built. The chapter is well illustrated, with color diagrams and schematics. The second chapter deals with neuroimaging in neuro- ophthalmology. It includes helpful tables and practical summaries of when to order, what to order, and how to order such studies. It includes newer and less prevalent techniques such as MRI spectroscopy, PET scanning, SPECT scanning, functional MR, and multifocal ERG. The third and fourth chapters shift emphasis to the patient with decreased vision and lead the reader through a focused approach to differential diagnosis. These chapters are organized by clinical signs- decreased vision with or without a relative afferent defect, with a normal- appearing nerve head, or with disc edema. All the common optic neuropathies are covered ( as are less common ones); indeed, some retinal processes that wind up in the neuro-ophthalmologist's office are discussed, including cone- rod dystrophies, cancer- associated retinopathy, and acute zonal occult outer retinopathy. Ensuing sections describe transient visual loss, disorders of higher cortical dysfunction, nystagmus, anomalous motility, and diplopia. Subsequent chapters walk the reader through pupillary anomalies, facial nerve issues, headache, and functional visual loss. The last chapter summarizes selected common systemic conditions associated with neuro- ophthalmic signs and symptoms, including myasthenia gravis, thyroid orbitopathy, and the neurocutaneous syndromes. Strengths: This small volume systematically covers the essentials of neuro- ophthalmology that the practitioner need consider. It is remarkable in its breadth. The material is presented practically, speckled with wonderfully illustrated cases, up- to- date scanning, and visual field correlates. The underlying anatomy is emphasized, and treatment possibilities are summarized. Weaknesses: The authors are such authorities and experts in their field, with so much experience and so much to offer, that occasionally the casual reader will be overwhelmed by detail, especially in the chapters on nystagmus and motility ( should " oculomasticatory myorhythmia" have been included?). Also, some terms may not be familiar to the ophthalmology residents, such as " fascicle" and " long tract signs". And yet, one is hard pressed to find lapses in this pithy and paramount overview. Recommended audience: This volume is designed for the ophthalmology resident and re- certifying ophthalmologist. It will also be useful for neurologists in training. Critical appraisal: The authors ( Newman, Arnold, Friedman, Kline, Rizzo, and O'Connor) are to be congratulated for assembling an innovative, practical, well organized summary of neuro- ophthalmology that is simply and elegantly presented, well written, and highlighted with timely references. This is a readable, one- volume, all- you-need- to- know package of the neuro- ophthalmology seen in community practice, with its underlying basic science. It is fine testimony to the success not only of the authors, but also of the educational program of the American Academy of Ophthalmology. Barrett Katz, MD, MBA The George Washington University Washington, DC Clinical Neurophysiology of the Vestibular System Robert W. Baloh, MD. Oxford University Press, New York NY, 2001. ISBN: 0195139828, Order No.: 800- 451- 7556, Price: $ 98.50 Scope: Written by two highly respected contributors to the study of vestibular disease, this book seeks to provide a framework for the understanding of the pathophysiology of vestibular disorders. During the past decade, considerable advances have been reported in the basic scientific principles underlying vestibular disease and their clinical applications. This third edition of a well known textbook has been reorganized and expanded to take into account these developments, and it includes new concepts that explain peripheral transduction and central processing mechanisms within the vestibular system. Following a fundamental dis- Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. JNeuro- Ophthalmol, Vol. 22, No. 2, 2002 BOOK REVIEWS cussion of the anatomy and physiology of the vestibular system, the book focuses on the evaluation and management of the dizzy patient, along with a comprehensive consideration of all aspects of vestibular disease. Overall, there is a structured approach from an explanation of the basic science of vestibular mechanisms through clinical assessment, both bedside and laboratory, of vestibular disorders, and ending with drug and rehabilitation treatment of the vertiginous patient. Contents: This book is divided into four parts. In part one, there is a detailed explanation of the anatomy and physiology of the vestibular system, both central and peripheral, including an appraisal of the vestibuloocular reflexes and their interaction with other systems. Part two is an evaluation of the dizzy patient, emphasizing the history, bedside examination, laboratory investigations, and clinical assessment of hearing. Part three addresses the diagnosis and management of common neurotologic disorders, including infectious disorders, benign positional vertigo, Meniere syndrome, migraine, immune mediated diseases, vascular disorders, tumors, trauma, toxic/ metabolic disorders, and developmental and genetic disorders. Part four describes the symptomatic treatment of vertigo with an evaluation of antiemetic and antivertigo drugs and the rationale for and design of a vestibular exercise program in rehabilitation. The text contains extensive diagrams and tables, along with some imaging and pathology illustrations. At the end of each chapter there is an extensive bibliography. Strengths: This book provides a comprehensive and up- to-date review of the neurophysiological mechanisms underlying vestibular disorders and their clinical features. The presentation is orderly, readable, and authoritative, while the line diagrams helpfully illustrate underlying morphology and physiological mechanisms. The detailed approaches to the history of the dizzy patient with the bedside and laboratory evaluations are particularly informative. The differential diagnosis of the many causes of dizziness provides an extensive background to the appropriate investigations, while the symptomatic treatment section includes not only drugs and their actions, but also the important issue of vestibular rehabilitation. Deficiencies: The chapters on diagnosis could have benefitted from more extensive and targeted state- of- the-art imaging illustrations ( magnetic resonance angiography in vertebrobasilar insufficiency), and the description of the pathology of vestibular disorders might also have been enhanced by further histologic illustrations of, for example, the brain stem. A more extended discussion of the potential management of oscillopsia using, for example, gabapentin, botulinum toxin, or ocular muscle surgery would have been useful. Recommended audience: This text is primarily aimed at neurotologists but also neurologists, neurosurgeons, and general physicians involved in the care of patients complaining of dizziness. However, neuro- ophthalmologists will also find much of considerable value in this reference text to assist in their understanding, investigation, and management of vestibular disorders. Critical appraisal: The evaluation and treatment of the dizzy patient presents a difficult and often enigmatic problem. This book provides a thorough explanation of the mechanisms underlying vestibular disorders and a comprehensive review of their evaluation and treatment. It provides an invaluable aid to the assessment of dizziness. Robert M. McFadzean, MD Southern General Hospital Institute of Neurological Sciences Scotland, UK A Compendium of Degenerative Brain Diseases Larry G. Baratta, MD, PhD. Charles C. Thomas, Springfield, IL, 2001. ISBN: 0398071543, Price: $ 26.95 Scope: This is a single- authored, soft- cover bird's eye view monograph addressing neurodegenerative disease. Contents: This is a concise, focused exposition of the neurophysiology and neuropharmacology of the more common neurodegenerative disorders seen in clinical practice. The text is presented in outline form in three chapters. The opening chapter reviews basic neurophysiology, with an emphasis on the autonomic nervous system and common neurotransmitters. The many excellent diagrams and tables provide a quick and easy reference guide for those preparing for board examinations. The neurotransmitters reviewed in this section include acetylcholine, norepinephrine, dopamine, serotonin, and GABA. Disappointingly, there are no discussions of glutamate, of the NMDA receptor, or of excitotoxicity. The second chapter reviews in bullet format the common clinical neurodegenerative disorders, including Alzheimer disease, Parkinson disease, Pick disease, Huntington disease, and amyotrophic lateral sclerosis. This section is cogent, well organized, and easy to read. A brief discussion of the pathology, clinical features, etiology, diagnostic criteria, and treatment of each disorder is provided. The last chapter is lengthy and dedicated to a review of the various medications used to treat degenerative disorders. Medications discussed include the cholinesterase inhibitors, anticholinergics, and dopaminergic agents. This section is in tabular form and includes information about indications, contraindications, dosing, and side effects. The chapter is supplemented by excellent illustrations that depict the mechanisms of action of the described agents. „ 148 . , „ . , „ . . © 2002 Lippincott Williams & Wilkins , Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. BOOK REVIEWS JNeuro- Ophthalmol, Vol. 22, No. 2, 2002 Strengths: The book provides a concise, easy- to- read discussion of the common neurodegenerative disorders and the standard drugs used to treat them. Weaknesses: Less common conditions that are relevant to the neuro- ophthalmologist, such as progressive supranuclear palsy, cortical basal ganglionic degeneration, and the spinocerebellar ataxias, are not covered. Given the relatively brief description of each entity, evolving subtle issues are omitted, including the importance of tau protein in Alzheimer disease and the role of genetic testing in some of these disorders. Recommended audience: The book is intended for a wide audience: medical students, residents, and specialists. The former will benefit from it more than the latter. The restricted scope of this monograph will limit its usefulness for those who are ultimately responsible for making decisions about patients with neurodegenerative disease. Critical appraisal: I enjoyed reading the book and found the information provided to be useful. The arena of neurodegenerative disease is one of intense investigation, and some of the material is dated. Although the text was created for a wide readership, this book will prove to be most useful for neurology and psychiatry residents preparing for board examinations. Steven L. Galetta, MD University of Pennsylvania Medical Center Philadelphia, PA Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. |