386 Book Review / Electroencephalography and clinical Neurophysiology 94 (1995) 385-388
authors from undertaking similar attempts to make an interesting and significance of depression of activity is well stated. There is a new brief
useful scientific tool accessible to all. section on the elderly, plus a complex and detailed figure of normal EEG
Writing on molecular genetics can be surprisingly difficult. Although patterns as a function of age and state of alertness. The helpful and rarely
the general concepts embodied in the science are actually quite simple discussed complications of the EEG and the EEGer in medico-legal
and straightforward, the details can be daunting, and yet it is in the details situations are retained.
that true understanding lies. Reconciling these problems requires not only Dr. Hughes properly differentiates between brain death and cerebral
understanding of the topic, but also familiarity with the knowledge base death. He retains faith in double-distance derivations. Thus, records from
(or lack thereof) of the intended audience, as well as extraordinary 8-channel instruments necessitate use of only 9 of the basic 19 scalp
writing skill in explaining the more confusing details without losing the electrodes for ECS determination. There is much emphasis on artifact
reader in unnecessary details. identification and the critical importance of sensitivity. It is difficult to
The basics of Mendelian inheritance are covered in the first chapter of believe that 8-channel instruments with reduced electrode coverage are
the book, and here are seen the basic flaws of the book. In an attempt to often used for ECS determination.
be simple and brief, some concepts come across as confusing, and others There is still a somewhat "dated" flavor to this highly personal EEG
are given more prominence than necessary. For example, 3 pages are book. It is avowedly not written for qualified EEGers and, by implica-
devoted to the Hardy-Weinberg law, a concept applicable only to ran- tion, for the more than 2600 ABRET boarded technologists. The 1951
domly mating populations, making it of questionable value to human terminology of 1 0 / s e c alpha has been updated only to "10 c / s e c , "
populations (and certainly to clinicians). The fact that the law is never rather than to Hz. Likewise, "resistance" is used for impedance and
again mentioned in the book is good evidence of its lack of relevance. "amplitude" for voltage.
Although the author does quite well in his historical overviews of the Other idiosyncratic features involve the persistent use of the passive
topics covered in this book, the problem of balancing simplicity with the voice and a very liberal use of boldface and italics. The index lists a
necessary detail is a problem throughout the book. plethora of acronyms, including BETS, BORT1~, DB, FIRDA, FOLD,
There are many other books available that provide a good introduc- FAR, HVS, IDR, PLEDS, PLEDSPLUS, PTO, POSTS, RMTD, SEM,
tion to the basics of molecular biology. "Recombinant D N A " by Watson STOP, and WHAM, many .of which may not be familiar to the reader.
et al. is probably the best example. Where "Molecular Genetics for the The more common acronyms of REM, NREM, SSS, etc., etc. will fare
Physician" is more valuable in its reviews of what is known of the better.
molecular biology of heritable diseases and cancers. However, these brief All bibliographies must reflect the interests of the writer(s); thus, 10%
reviews are not sufficiently complete to serve as references by themselves of the 222 citations in this book refer to Hughes. Despite the limited
nor are they current (for example, almost nothing of mitochondrial addition of some new material, the book succeeds in its avowed purpose
disorders is addressed). of presenting EEG to the relatively unsophisticated physician.
If this book is truly intended for clinicians, it needs to be revised.
C.E. Henry
Leland J. Scott Department of Neurology,
Developmental and Metabolic Neurology Branch, Medical College of Virginia,
National Institutes of Health, Richmond, VA (USA)
Bethesda, MD (USA)
Essentials of clinical neurophysioiogy. - K.E. Misulis (Butterworth-
EEG in clinical practice (2nd edition). - J.R. Hughes (Butterworth- Heinemann, Boston, MA, 1993, 306 p., Price: US $75.00)
Heinemann, Boston, MA, 1994, 242 p., Price: US $59.95)
The goal of this book, as outlined in the preface, is " t o provide the
While searching for my copy of the 1982 edition of this book (loaned, reader with a single source to guide competent performance and interpre-
as usual, and, as usual, not returned), I chanced to look at the by-now rare tation" of clinical neurophysiological tests including electroencephalogra-
copy of what is inarguably the first American book on clinical EEG. phy (EEG), electromyography (EMG), nerve conduction studies, evoked
Robert S. Schwab in 1951 used the same title and his book sold for $6.50. potentials (EPs), and polysomnography. This is a worthy goal but,
After considerable delay, I obtained a library copy of the Hughes first unfortunately, it has not been satisfactorily achieved by the present
edition. Between August, 1985 and May, 1992, it had been borrowed 21 volume. The subject matter is generally presented in a superficial and
times. With the world-wide plethora of EEG books in the last several uncritical manner. In some instances the information is either inaccurate
decades, this is a respectable number. It is a compliment to the author, or, at least, confusing. For example, in the section on basic electronics,
there being so few single-authored contributions any more, that the considerable length is devoted to the proof of very simple relationships
publishers urged a second edition. such as the equivalent resistance in serial and parallel circuits (p. 16-19)
This new edition has a more efficient typeface for both figures and whereas for more complex derivations, such as the Goldman equation, the
text which are, nevertheless, more or less identical to those of the first result is simply stated. In either case the derivation is not really necessary
edition through page 43 and throughout most of the book. Hughes has and the reader could simply be referred to a more authoritative source.
corrected a curious reversal of electrode lateralization. There is a very Moreover, whether stated or derived, the material is often presented in a
simple account of electrode placement, montages and polarity. Text and confusing manner. Thus, for the Goldman equation (p. 7) the relationship
figures are technically free of error but given in numbingly excessive between conductances and equilibrium potentials is not stated and the
detail. There is little reference to such matters by other workers. Although dependence of the Nernst equation on temperature is not mentioned. In
this simple topic has been much overemphasized, no competent EEGer or the discussion of resistors the author defines (p. 17) the equivalent
technologist has a problem with polarity nowadays. All assume that resistance in a circuit (R,q) and, on the following page, he changes this
h e / s h e has the solution. The infallible rule for this reviewer and for terminology (without any definition) to R t. As another example from this
Schwab is that when input 1 is more negative, the pen invariably goes up section, he discusses the problem of aliasing (p. 39) which occurs when
and all else follows inexorably. the digitization rate is too slow for the signal frequency being digitized.
The brief summary of abnormal EEG patterns and associated clinical However, in Fig. 4.8 he mistakenly presents, as an example of aliasing, a
conditions retains sensibly cautious admonitions regarding specific rela- sine wave that has been digitized at an appropriate rate to avoid aliasing.
tionships. It is helpful in listing the wide range of possible etiologies. The Also, in his discussion of artifacts, he discusses the improvement in
reader can even learn about mitten patterns, both A and B. The possible signal-to-noise that occurs with averaging (p. 81) but he fails to discuss
