EEG and evoked potentials in psychiatry and behavioral neurology

EEG and evoked potentials in psychiatry and behavioral neurology

Electroencephalograph), and clinical Neurophysiology, 1984, 59:175 175 Elsevier Scientific Publishers Ireland, Ltd. BOOK REVIEW edited by H . P E...

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Electroencephalograph), and clinical Neurophysiology, 1984, 59:175

175

Elsevier Scientific Publishers Ireland, Ltd.

BOOK

REVIEW

edited by H . P E T S C H E

and J O H N

R. HUGHES

EEG and evoked potentials in psychiatry and behavioral neurology. - - J.R. Hughes and W.P. Wilson (Eds.) (Butterworth, London, 1983, 411 p., U.S. $29.95) This book has been prompted by the need for a new version of the 'Applications of electroencephalography in psychiatry' edited by William P. Wilson (Duke University Press, 1965). John R. Hughes has been responsible for this new volume with the assistance of 9 contributors. The book comprises a considerable portion of the behavioral sciences but deliberately avoids the controversial issues surrounding the theme of epileptic seizure disorders and psychiatric implications. This is a well written book; its style is more homogeneous than one would expect from a multitude of contributors. This also reflects the quality of Hughes' editorial work. The selection of references is very satisfactory; even the academically oriented reader will be pleased. The content of the book is very well designed. The opening chapter deals with the EEG in organic brain syndrome (by R.D. Weiner). This latter term - - never appealing to the neurologist but very practical for the psychiatrist - - is well explained. This useful chapter suffers from the absence of EEG illustrations. The hotly debated issue of the dementias could have benefitted from more extensive coverage. The same author also provides an excellent chapter on ' E E G related to electroconvulsive therapy' (chapter 6) which leaves nothing to be desired; it even includes a discussion of stimulus wave form and intensity. Joyce G. Small is the author of the chapters 2 and 3 on schizophrenia and affective disorders. These are indeed difficult topics when one takes into account the high prevalence of normal EEG findings. While this is true for pure forms of schizophrenic as well as manic-depressive psychosis, a number of organic conditions may be associated with signs of psychosis ( ' E E G studies may identify subgroups who have distinguishing clinical attributes'). These two very interesting chapters do not present any illustrations. Chapter 4 on ' E E G alcohol and alcoholism' by Kelley and Reilly is quite comprehensive (with the exception of illustrations); this chapter also contains a fine section on evoked potentials. Chapter 5 on EEG and psychotropic drug (by E.L. Reilly, K. Reed and J.T. Kelley) is also highly satisfactory (the highlight: a very good discussion of EEG and lithium). Aspects of automatic frequency analysis are included. The most important illegal street drugs are briefly presented. In chapter 7, D.J. Kupfer and C.F. Reynolds, III, discuss the polysomnographic aspects of psychiatric disorder. This includes (a) an illustration of typical sleep profile in normal, depressed and

schizophrenic individuals, and (b) a diagnostic classification of sleep and arousal disorders. The character of the book changes considerably with C. Shagass' chapters 8 and 9 (CNV and other slow potentials in adult psychiatry,' 'Evoked potentials in adult psychiatry'); these chapters are exclusively devoted to event-related potentials. According to Shagass, there is substantial evidence that eventrelated slow potentials show certain deviations in a psychiatric population while effects of psychoactive drugs have not been consistent. The discussion of evoked potentials impressively demonstrates the attempts of an electrobiologically oriented psychiatry to establish correlates of abnormal neurophysiology for certain psychiatric conditions. Time will be the ultimate judge of successes and failures. The discussion of the VEP would gain from a careful distinction between flash- and pattern-reversal-induced responses. The most important psychoactive drugs are included. Mary R. Andriola contributed chapters 10 (EEG and EP in learning disabilities), 11 (EEG in mental retardation) and 12 (EEG in childhood psychiatric disorders). These chapters are well written and please the reader with a good number of EEG illustrations. The title ' E E G in mental retardation' is a misnomer; the reader will gratefully realize that Andriola presents a fine review of degenerative CNS diseases, cerebral palsy and severe forms of childhood epilepsy such as infantile spasms and Lennox-Gastaut syndrome. The final 4 chapters (13, 14, 15 and 16) are the work of J.R. Hughes. Chapters 13-15 represent reviews of EEG patterns with psychiatric implications: the positive spike phenomenon, the 6/sec spike-wave complex and small sharp spikes. Hughes has channeled much time and energy into the study of these 3 patterns but he objectively weighs the opinions of other workers in the field so that the reader can personally decide about the degree of abnormality and clinical significance in each of these EEG phenomena. The result is a well balanced scholarly review with excellent bibliographies. An eminently practical chapter 16 entitles 'The medicolegal EEG~ concludes the book. The book is most warmly recommended to every electroencephalographer and to those neurologists and psychiatrists with special interest in that fascinating gap which lies between CNS and 'psyche' - - a topic which has enticed (and so often eluded) a cohort of electrophysiologists from Hans Berger to John C. Eccles.

0168-5597/84/$03.00 © 1984 Elsevier Scientific Publishers Ireland, Ltd.

ERNST NIEDERMEYER

Johns Hopkins University School of Medicine and Hospital, Baltimore, MD 21205 (U.S.A.)