Immunoelectrophoresis

It seemed for a while that among the many losses suffered by neurology after Lord Brain's death might have been the popular series of "Recent Advances in Neurology and Psychiatry," which he had edited for many years. Happily, however, this series has been restored and rejuvenated under the editorship of Professor Bryan Matthews. He has adopted the technique of selecting a number of topics to be dealt with in detail in which significant advances have been made in the last decade rather than trying to cover the whole field of neurology, and has invited a different author for each section, choosing those with a special interest and knowledge of that subject. Indeed several have already written larger monographs on the particular subject. The development of ideas on the role of the somewhat neglected right cerebral hemisphere is reviewed by Dr J W Oxbury. He shows how important its function may be in perceptual analysis, and how damage to its interconnections with the left hemisphere is important in many of the more complex disturbances of cerebral function. Dr Gilbert Glaser considers new facets in the study of epilepsy, including the importance of convulsions in early life for the development of later temporal lobe attacks, and he describes new automated electroencephalographic techniques in the investigation and control of seizure patterns. He emphasises again how studies of blood levels of anticonvulsant drugs are of great value, and how this may show that interaction of drug combinations may raise or lower their levels, often to an undesirable degree. Dr E C Hutchinson writes a clear, concise summary of his and others' work on cerebrovascular disease, showing what has been learnt from bloodflow studies and the importance of hypertension, as well as, but distinct from, atheroma in many cerebrovascular accidents. A most informative chapter by Bryan Ashworth on the new neuro-ophthalmological investigations such as electroretinography, the use of fluorescein, and orbital phlebography, is followed by short cameos of unusual neuro-ophthalmological diseases about which information is difficult to find. What is known, or thought to be known, of the aetiology and chemistry of Parkinson's disease and the rationale for and degree of success of various forms of treatment is dealt with by Dr Clifford Mawdsley, who rightly stresses that the troublesome dyskinesias of levodopa treatment are not necessarily reduced by the decarboxylase inhibitors, as is sometimes unjustifiably claimed. Professor Matthews's own contribution reflects his interest in the virus infections of the nervous system, of which of course herpes simplex encephalitis, subacute sclerosing panencephalitis, and the spongiform encephalopathies occupy most attention. But many others are mentioned as well, and the role of the "slow" viruses is critically examined. Delays from writing to publication are inevitable, and it might appear that herpes encephalitis is being most commonly treated with idoxuridine rather than cytosine arabinoside, and it must be remembered that the value of these haemotoxic drugs as opposed to simple decompressive measures has not yet been clearly defined. The big surgical problems of intracranial vascular anomalies and syringomyelia are dealt with by Mr Huw Griffith and Dr J B Foster respectively, and Dr Harold Millar's lifelong interest in the aetiology and epidemiology of disseminated sclerosis is clearly portrayed in a chapter on demyelinating diseases. Here it is good to see that the value of the y globulin level in the cerebrospinal fiuid is stressed, and a value lower than most people give is suggested as being significant. Professor K P Thomas summarises the never ending problem of peripheral neuropathy, and Professor Bradley writes an informative, concise chapter on inherited muscle disease. Each chapter has a wealth of references (over 300 following some), and if the book is larger and longer and yet more restricted than its predecessors it gives a great deal more detail and indications for wider reading. Somehow or other the style of writing and presentation is in a uniform manner throughout-no mean task with so many authors and making it far easier for consecutive reading. Postgraduates of all degrees of seniority will gain from reading these chapters, and those already engaged in neurological practice will find much they did not already know. It is to be hoped the subsequent editions will maintain this high standard of authorship and presentation, for subsequent editions there must surely be.