BOOKS

Reviews Pediatric Epilepsy: Diagnosis and Therapy Edited by W. Edwin Dodson and John M. Pellock New York, Demos, 1993 446 pp, illustruted, $89.95

This multiauthored book is a comprehensive but concise and well-referenced textbook devoted to epilepsy in children. The book contains a more complete review of seizure disor- ders in children than any single textbook of neurology or pediatrics, but it is not so extensive as the recently published, The Treatment of Epilepsy: Principles and Practice, edited by Elaine Wyllie. Divided into five broad categories, the greatest strengths of this book are in the chapters devoted to descrip- tions of the epileptic syndromes and to therapy, where the general principles of seizure management and pharmacology of antiepileptic drugs are very clearly described. Relatively minor problems are ( I ) the omission of an overview chapter on the genetics of epilepsy; (2) the index, which for a few conditions lists the same entity under different entries, or in a few instances, secondary discussions of topics are not referenced; and (3) the chapter on epilepsy surgery, which is heavily weighted to the experience of one center, although it is illustrative of the pathology underlying intractable epi- lepsy. These problems aside, the overall quality of the writing is very good to excellent and the book provides an accessible resource for all practitioners and residents caring for children with seizure disorders.

William H . Trescher, M D

Transcranial Doppler Ultrasonography Edited by Viken L. Babikian and Luwrence R. Wechsler St Louis, Mosb-y-Yeur Book, I993 323 p p , illustruted

This compact book crowds into 323 pages of small print and excellent illustrations a compendium on this burgeoning subject. Carefully written and thoroughly documented chap- ters take the reader through introductory physics to the far- thest extremes of use of the technique. Even the details of embryology are covered, as well as practical hands-on chap- ters from experienced users. It seems likely to become a classic in the field with only a few competitors.

It has been difficult to fathom the slowness of acceptance of this technology among neurologists, the principal benefi- ciaries. Training in Doppler remains a small part of residency programs. Yet with proper training, transcranial Doppler (TCD) can, within minutes, assess the patency of large arter- ies; document right-to-left shunts or arteriovenous fistulas and the frequency (even the type) of emboli passing into the brain’s circulation; assess the course of vasospasm, stenosis from arteritis, or recanalizing embolism; study the presence of compensatory collateral circulation in severe occlusive dis- ease. And all with a tool only a bit larger than an overnight

suitcase, small enough to be taken in the trunk of a car, wheeled around on a small cart, used in the emergency ward, office, ICU, or operating room.

With luck, this book may hasten the slow dawn of aware- ness of new opportunities for those interested in cerebrovas- cular disease. Those who revel in an active role in diagnosis and management already delight in the utility of this tech- nique and readers unfamiliar with T C D heretofore will find reasons for trying it.

The book may also have another effect. Until now, the small size (low price) and specialized use has not much at- tracted the attention of directors of laboratory services accus- tomed to taking technologies away from neurologists and neurosurgeons. As ever, neurologists have made little effort to get the new technology established in the minds of regula- tors and third parties; as usual, they have spent much time distracted by whether TCD can solve all of the problems posed (easy answer here) and whether total flow is being measured or whether velocity profiles and resistivity indices suffice (as they clearly do and is amply documented in this volume). The newer color-coded machines have raised entry costs to the levels familiar to the bigger players in technology and the rapidly rising frequency of T C D use has forced some consideration of billing codes and the like. This easily read and compact book could well convince those outside neurol- ogy it is time to take over TCD, on the one hand, and provide billing codes, on the other. Neurologists and neurosurgeons should at least share in this process with the later-arriving anesthesiologists and radiologists-dare I suggest even con- trol it?

J . P. Mohr, MS, M D

Inherited Ataxia . Advances i n Neurology, Vol 61 Edited by A. E. Harding and Thomas Deufel New York, Raven, 199.3 21 7 pp, illustrated, $95.00

Among neurodegenerative disorders, the hereditary ataxias are notoriously difficult to sort out. The field has been a confusing battleground of lumpers versus splitters, and over the years D r A. E. Harding has proved a capable guide through the fray. H e r lectures and written reviews have helped to clarify this set of disorders, a process facilitated recently by genetic linkage analysis.

The current volume is based on a meeting held in 1990. It contains a clinical review by D r Harding and articles about cerebellar anatomy and physiology and research in various cerebellar disorders, including prospects for therapeutic in- tervention. This field is evolving quickly, and we are shown a snapshot that is already beginning to fade with time. These reviews may soon be superseded by new research advances. Dr Harding’s clear-thinking approach to diagnostic classifica- tion will likely have the most enduring value.

Kenneth H . Fischbeck, M D

Copyright 0 1993 by the American Neurological Association 419