Behavioral Neurology, ed 3

Behavioral Neurology, ed 3

BOOK REVIEWS Behavioral Neurology, ed 3 By Jonathan H. Pincus and Gary J. Tucker. New York. Oxford Universily Press. 1985.322 pp. S24.95 hard cover, S...

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BOOK REVIEWS Behavioral Neurology, ed 3 By Jonathan H. Pincus and Gary J. Tucker. New York. Oxford Universily Press. 1985.322 pp. S24.95 hard cover, SIO.95 paperback.

• The first edition of this book appeared in 1974, and it was recognized from the beginning to be an exceptional contribution. Since its appearance, several additional books have been published in the areas of behavioral neurology and neuropsychiatry, but none challenge the originality or readability of Behavioral Neurology. The new edition is 40 pages longer than the second edition and more than 100 pages longer than the first. Coverage of pseudoseizures, the relationship of limbic system dysfunction to violence, usefulness of CT scans in behavioral disturbances, and memory disorders has been updated and expanded. Throughout, however, the readable style and application of a practical, informed approach to solving common neuropsychiatric problems is retained. The volume is divided into six chapters, covering the areas of seizure disorders; limbic system and violence; schizophrenia; disorders of intellectual function; movement disorders, depression, psychosis, and sleep; and distinguishing neurologic from neurotic disorders. The chapter on seizure disorders addresses the basic areas of epilepsy diagnosis, treatment of seizures, and the genetics of idiopathic epilepsy, as well as the relationship between epilepsy and psychosis and epilepsy and personality alterations. The common association of depression and epilepsy is underemphasized, but many important points concerning the association of epilepsy and interictal behavioral alterations are made.


The chapter on the limbic system and violence is excellent. It explores the rare occurrence of violence in the course of seizures, and also examines the relationship of violence to child abuse and alcohol consumption. The chapter concerning schizophrenia takes an explicitly neurologic approach to this complex disorder and reports the genetic, electroencephalographic, CT, psychological, and pharmacologic data that convincingly indicate that schizophrenia is a disease of the brain and, most probably, of the limbic and dopaminergic systems of the brain. The chapter on disorders of intellectual functioning presents information regarding frontal lobe syndromes, parietal lobe disorders, aphasia, amnesia, dementia, delirium, split brains, and childhood psychosyndromes, such as autism and attention deficit disorder. An unusually conservative approach to cerebral localization is taken and the dementias are discussed only superficially, but the chapter calls attention to the complicated behavioral changes that may follow focal brain lesions. The chapter devoted to movement disorders, depression, psychosis, and sleep emphasizes Parkinson's disease, chorea, depression, and narcolepsy. This chapter is more phannacologically oriented than the others; it updates the information concerning each of the syndromes described and points to areas where new developments are likely. The final chapter, on distinguishing neurologic from neurotic disorders, discusses headache, hysteria, and hyperventilation syndromes. The importance of diagnosing hysteria only when there is no alternate explanation for the symptom and when the patient has a history of psychophysiologic

disturbances is emphasized. Together the chapters provide an overview of behavioral neurologic and neuropsychiatric topics that has both depth and breadth. The style holds one's attention and imparts a remarkable amount of information. The book deserves its reputation as a model of neuropsychiatric exposition, and this new version continues the exemplary tradition begun by the first two editions. JejfreyL. Cummings. M.D. University o/California Los Angeles

Ethics in Mental Health Practice Ediled by David K. KenlSmith, Susan A. SalIaday, and Pamela A. Miya, Orlando, F1a, Grone & Stratton, 1986,254 pp, S34.50.

• This multiply edited and authored volume considers a selection of ethical issues in mental health practice that, in the opinion of its editors, were thought to be "among the most pressing." Two introductory chapters sketch a framework for conceptualizing ethical approaches to professional practice. The remaining chapters cover topics on informed consent, children, the aged, consultation-liaison, sex therapy, religious aspects of psychotherapy, and mental health policy. Viewed as a descriptive illustration of the state of the ethical debate in the mental health professions, this collection provides an instructive, if incomplete, overview. But with the notable exception of Chapters 9 and 10, the book does not contribute new data or insights to the literature already available. The two best chapters are "Roles, contracts, and covenants: An analysis of religious components in psychotherapy," by Brandsma, Patti-