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J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.46.4.375-b on 1 April 1983. Downloaded from Journal of Neurology, Neurosurgery, and Psychiatry 1983;46:375-376 definition by trained transcribers with an tumours in childhood. Book reviews interexaminer reliability of F = 0-81 fol- These volumes are much recommended Gilies de la Tourette Syndrome Volume 35 lowed by 2-way Anovas with blocking for to all neurosurgeons who wish to be of Advances in Neurology. Edited by subject pairs to compute F ratios for com- acquainted with the "state of play" in Arnold J Friedhoff and Thomas N Chase. paring the mean Z scores on each language paediatric neurosurgery. The editors are, (Pp 478; $58.90.) New York, Raven Press. function. This is incomprehensible as well however, very naive if they believe, as they 1982. as meaningless. It is impossible to find out suggest in their preface to volume 2, that it whether clonidine is really useful or not or may be "possible for paediatric This volume contains the proceedings of whether haloperidol does possess definite neurosurgeons throughout the entire world the 1981 New York symposium on advantages over other neuroleptics. to provide their knowledge and care to the Tourette syndrome. The 67 papers are This is the second major work on Gilles benefit of all children". At least 1000 mil- organised into 10 main sections, clinical de la Tourette's syndrome to appear in 4 lion of the world's population are provided and historical over-view, neuro-anatomy years, the first edited by the Shapiros, with very few neurosurgeons (for the and neuropathology, neurophysiology, Bruun, and Sweet. Although de la Tourette treatment of adults and children)-about biochemistry, animal models, genetics, recognised that the illness was a movement 1% of the proportion serving the USA. epidemiology and population studies, disorder, not a form of madness or insanity, Paediatric neurosurgery must have a very psychology and psychiatry, neurology and the wealth of neuroscience in this book low priority in those areas. speech pathology, and clinical pharmacol- contributes little to understanding the syn- KENNETH TILL ogy. Despite a total of 444 pages plus index drome. To be more than a record the pub- written by a total of 148 contributors, the lication of conference proceedings needs nature and origin of Gilles de la Tourette's more careful selection, more detailed Maturation and Development. Biological syndrome remain unknown, the pathology editorship and more critical comment than and Psychological Perspectives. Edited by is virtually non-existent and any relevant appear here. Kevin J Connolly and Heinz FR Prechtl. neurochemistry at best fragmentary. Selec- JD PARKES (Pp 326; £15-00.) London: Spastics tive reading is therefore required. The best International Medical Publications, 1981. section in the book is the introduction with the re-appearance of Murray's delightful Concepts in Pediatric Neurosurgery, Vols The concepts of development of the Protected by copyright. essay on Samuel Johnson's movement dis- 1 and 2. The American Society for Pediatric maturation, although seemingly straight- order and also the first English translation Neurosurgery. (Pp 222; SFr 190, DM 228, forward, have proved problematic in of Gilles de la Tourette on Tourette's syn- $114.00 each.) Basel: S Karger AG, 1982. practice. As Dr Ronnie Mac Keith, to drome. The next section, that on neuro- whom this set of essays is dedicated, often anatomy and neuropathology reviews dif- These two volumes are the first of a con- pointed out, the terms tend to be used ferent aspects of monoamine and peptide tinuing series to provide a forum for those interchangeably as both empirical des- systems in the brain but contains little of who can contribute to the burgeoning spe- criptors and as explanatory theoretical direct relevance to the book's title, apart ciality of paediatric neurosurgery. constructs-a dangerous mixture as the from Richardson's review of two negative Although, no doubt, many of the chapters outmoded concepts of instinct and drive necropsies on ticquers. Peptides, cerebro- are derived from recently published pap- showed. Moreover, as explanations the spinal fluid amine metabolites, and the sub- ers, they provide under the heading of terms tend to assume more knowledge on stantia nigra all appear in the 80 pages on "Concepts" more considered accounts of brain-behaviour relationships than actually biochemistry, again usually without direct past experience and a more sober review of exists. I rather doubt that Ronnie would relevance to Tourette' s syndrome. The present progress than one obtains in the have been satisfied by the answers provided animal models of neuropsychiatric disorder usual proceedings or symposiums which in this book although, certainly, he would in rats, mice, rabbits, hampsters, guinea- often masquerade as a new book. have been pleased that the topic has been pigs and the like, show enormous ingenuity In such a rapidly developing field, it is given a critical scrutiny. The volume is too but rarely mimic Dr Samuel Johnson's ges- extremely important for those fortunate lacking in integration to be wholly satisfying http://jnnp.bmj.com/ ticulations, tics, or compulsive behaviour. enough to be acquiring extensive experi- but it contains much of interest and value. The genetic and epidemiological data are ence to communicate this to others. Thus in Thus, Polani gives an authoritative and of major interest with detailed information these volumes there are chapters on par- readable account of chromosomal mech- on the very high frequency of ticquers in ticular tumours (craniopharyngioma, anisms and developmental anomalies, van different populations. Perhaps it is surpris- medulloblastoma etc.) on the value of par- Hof succinctly discusses developmental ing that haloperidol rather than vital ticular investigative procedures (met- issues relevant to the neural mechanisms energy is used to treat Chinese patients, rizimide CIT cistemography, telimetric underlying recovery from brain damage, but not surprising that HLA typing in pressure measurements) on particular and Judy Dunn provides a brief but American patients is no different from that treatment methods (cutaneous third ven- thoughtful discussion of maturation in on September 29, 2021 by guest. in American non-ticquers. In contrast to triculostomy etc) while other chapters pro- relation to early social development-to this brief section those on psychology, vide reviews of broader subjects such as a give three rather different examples. The psychiatry, language and clinical phar- comparison of different methods of tumour main weakness in the book concerns the macology are a little disappointing. The use treatment, neurosurgical management of psychological implications of the biological of jargon and over-classification can be myelomeningocele, management of uri- findings. Thus, little is said on brain- misleading as when analytical procedures nary incontinence; a chapter worthy of behaviour relationships, or on the effects of are used to classify vocal tics into eleven special mention is a summary of reaching puberty early or late or on some of different categories according to specific papovaviruses and the causation of brain the conditions (such as enuresis) in which 375 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.46.4.375-b on 1 April 1983. Downloaded from 376 Book reviews concepts of "maturational delay" are most advance in terms of selectivity and fre- decessors. The anatomy is comprehensive often invoked. Ronnie would have been quency of unwanted effects. What has also and provides satisfying detail for both the especially disappointed by the last of these interested psychopharmacologists is the neuroanatomy student and the clinician. omissions but perhaps it was not discussed great variation in pharmacological effects Although it remains a predominantly because the queries he raised have yet to be between the new antidepressants. As yet anatomical text, it includes adequate answered and because there is little new to there is no satisfactory correlation between descriptions of related physiology, and report. The book deserves to be widely read their clinical effects and pharmacological where relevant, clinical topics are as much for the implicit unanswered actions but if it can be demonstrated that explained in brief vignettes. Some of these questions that arise, as for the wealth of they are effective antidepressants it shows are masterpieces of succinct, accurate and factual information it provides. that the old catecholamine hypothesis of illuminating writing. MICHAEL RUTTER affective disorders is untenable. In this vol- The clinical applications of anatomy and ume there is undeniable evidence that sev- physiology are explained for example in eral of the newer drugs are highly effective tests of vestibular function, visual fixation Low Back Pain-Assessment and Man- antidepressants, including bupropion, and muscle stretch reflexes. The correla- agement. By Dan M Spengler. (Pp 160; zimelidine, trazodone and mianserin. It is tions of syndromes with disturbed anatomy $24.00; £16-00.) New York: Grune and also clear that several other drugs have and physiology are shown in spinal cord Stratton Inc. 1982. interesting pharmacological effects consis- lesions, and in the brain stem infarcts which tent with their use of antidepressants but spawn so many eponyms. These are all There are too many books on backache their clinical efficacy is still not proven described with commendable clarity and which simply re-write standard teaching fully. These drugs include clovoxamine, brevity. A highlight of the book is a mul- and it is a pleasure to find an exception. sulpiride, viloxazine and amoxapine. The titude of superb, simple, line diagrams and Most books start with anatomy and disease book is a companion text to volume 31 of figures, each carefully conceived and label- and proceed to medical technology. Speng- the series; this is concerned primarily with led. ler starts with the patient and his pain and the mechanisms of action of antide- Any subject with such wide ramifications proceeds to clinical decision making and pressants.

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