394 Matters arising J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.58.3.394 on 1 March 1995. Downloaded from patients to have features of Briquet's syn- sons. National and international referrals customers should add £2 per item for drome. would still be attracted, and the Institute, postage and packing. Payments can be G D PERKIN which would continue to be closely associat- Charing Cross Hospital, made by cheque in sterling drawn on a Fulham Palace Road, ed with the hospital, would be assured of a United Kingdom bank, or by credit card London W6 8RF, UK long term future. (Mastercard, Visa or American Express) High quality research and a first class 1 Ron MA. Somatisation in neurological prac- stating card number, expiratory date, and tice. J Neurol Neurosurg Psychiatry 1994;57: clinical service are the obvious objectives. your full name. 1161-4. They must both be achievable. There is now 2 Perkin GD. An analysis of 7836 successive new a unique opportunity to redefine the role of outpatient referrals. J Neurol Neurosurg The National Hospital. The exercise will Psychiatry 1989;52:447-8. Searching for the Causes of 3 Perkin GD. Pattern of neurological outpatient result in temporary inconvenience, disloca- Schizophrenia. By EVE C JOHNSTONE. practice: Implications for undergraduate and tion, and considerable expense. These can Published by Oxford University Press, postgraduate teaching. J R Soc Med 1986; surely be tolerated. Future generations of Oxford. (Pp 134). ISBN 0-19-262296-X. 79:655-7. patients and doctors will have cause to cele- brate the foresightedness of their forebears. This book consists largely of an account of British neurology: a national focus R LANGTON HEWER the work that Eve carried out University ofBristol, Johnstone Department ofNeurology, with a number of colleagues whilst she was We are grateful to Schapira and Marsden for Frenchay Hospital, a member of the Clinical Research Centre opening the national debate about the future Bristol BS16 1LE, UK Division of Psychiatry, of which I was privi- of The National Hospital and the Institute 1 Shapira AHV, Marsden CD. British neurology: leged to be the Head, between 1975 and of Neurology.' a national focus [letter]. 7 Neurol Neurosurg 1989. By 1988 the work of the Division on The National Hospital has, as the authors Psychiatry 1994;57:1 136. schizophrenia was more widely cited than of the letter state, been at the centre of neuro- that of any other department or institute in logical learning and development over many the world and this was in no small measure decades. In addition, it has been an impor- due to Eve Johnstone's tenacity and indus- tant centre to which difficult and unusual try. In addition to the first CT study of cases could be sent. I personally am grateful schizophrenia there were a series of clinical for the help that I have received from col- NOTICES trials-the flupenthixol stereoisomers study, leagues at The National Hospital over many the study of the adverse effects of anti- years. There will also be general acknowl- cholinergic druigs, The Northwick Park edgement for the excellent work done by the The 21st International Epilepsy Congress will be held on 3-8 September in study of first episodes of schjZpnhrenia and various units that go to make up the Institute the Northwick Park "functional psychosis" of Neurology. This work must continue. Sydney, Australia. Major topics are: Genetics and molecular study to which Eve Johnstone's contribu- Clinical service and research go together. biology of epilepsy; tion was pivotal and each of which to my Both should be practised to the highest pos- Surgical treatment of epilepsy in childhood; mind significantly clarifies major aspects of sible standards. Functional neuroimaging; Choice of drugs in the case of The National, in childhood the mechanism or scope of efficacy of an obvious potential conflict exists. Three and adult epilepsies; Epilepsy antipsychotic drugs. elements may be considered. and the law; Intellectual disabilities and This book gives a full and lucid account (1) Most patients prefer to be treated as epilepsy; and The role of psychiatry in of these studies; also of the major surveys of near as possible to their own home. epilepsy. For further information, contact: The Congress PO Box the defects of iJ.titutionalised patients with This would usually be in the nearest Secretariat, 1231, schizophrenia and the detailed follow-up of general hospital. There is consider- North Sydney, NSW 2059, Australia. Tel: + 61 2 956 8333; Facs: + 61 2 956 5154. patients admitted from a single Cadhment able agreement that referral further area (Harrow) over a 10 year period. This is afield should be the exception rather a substantial body of work and it is good than the rule, and there should that this succinct and factual account is on be sound clinical reasons for such Announcement from the British Neuro- record. referrals. psychiatry Association But is it justifiably described as Searching (2) Neurological disorders are charac- The 1995 Summer meeting-to include for the Causes of Schizophrenia? I noted http://jnnp.bmj.com/ terised by their frequency and their joint sessions with the British Associa- two curious omissions. The first relates to diversity. The vast majority of major tion for Psychopharmacology-will be the work we did between 1977 and 1983 on disorders such as stroke, head injury, held on 15-17 July in Cambridge the viral hypothesis. This surely represented and epilepsy are managed at general On 16 July BNPA will hold a scientific a "search for the causes of schizophrenia", hospitals throughout Great Britain. meeting with the theme of "movement dis- but it is not mentioned in the book. By The increasing number of neurolo- orders" and its AGM. On 17 July BNPAI 1984 I had come to the conclusion that gists now working mainly in such BAP will have a joint session on neuroimag- schizophrenia cannot be caused by an hospitals is ensuring an improved ing, psychiatry, and psychopharmacology. exogenous virus, a view which I suspect Eve spread of neurological expertise. Short scientific papers and single case videos Johnstone shares. But, if so, it would have on September 29, 2021 by guest. Protected copyright. (3) There are now well established neu- by members of both associations will also be been interesting (and relevant to the title) to rological units throughout the United presented. For further details please contact hear her reasons for dismissing the viral Kingdom and most of these are in Ms Sue Garratt, 17 Clocktower Mews, hypothesis, which at one time we both general hospitals. They provide a London NI 7BB, UK. entertained. Again the documentation of high quality clinical service as well as For details structural changes in the brain by CT, undertaking teaching and research. of membership of the BNPA, MRI, and in postmortem studies tells us These are three of the elements that influ- which is open to medical practitioners in something about the disease process. But ence the debate about the future role of The psychiatry, neurology, and related clinical what does it mean? I consider that a crucial National Hospital. The question now arises neurosciences, please contact Sue Garratt at clue came from the finding in the post- as to whether a "stand alone" specialist neu- the address above, or Dr Jonathan Bird, mortem work that the changes are asym- rological hospital with its somewhat atypical Burden Neurological Hospital, Stoke Lane, metrical. This suggests that they represent a and selective clinical practice, a decreasing Stapleton, Bristol BS16 1QT, UK. deviation in a late component of brain evo- number of referrals, and no local obvious lution, and leads to the more precise population to serve, is viable in the 1 990s. hypothesis that the disorder relates to The National Hospital would undoubted- genetic variation that is homo sapiens spe- ly achieve much support from clinical neu- cific. But this hypothesis and the aspects of rologists throughout the length and breadth BOOK REVIEWS the work which were relevant to it (even of the country if it were to physically merge though Eve contributed as coauthor) get no with a major general hospital. A major mention in this volume. advantage of this arrangement would be that All titles reviewed here are available from What I conclude is that there are scien- a high quality, comprehensive neurological the BMJ Bookshop, PO Box 295, London tists who are predominantly empirical or service for a defined population could be WC1H 9TE. Prices include postage in the Baconian in their approach and others who developed. Such a model service would be United Kingdom and for members of the are hypothesis driven. Eve is towards one most valuable for educational and other rea- British Forces Overseas, but overseas extreme and I am towards the other..