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Surgical treatment of Parkinson’s disease and other movement disorders
  1. P Bain

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    Edited by Daniel Tarsy, Jerrold L Vitek, and Andres M Lozano. Published by The Humana Press, Totowa, 2002, pp 353, US$165.00. ISBN 0-86903-921-8353

    The editors have assembled a panel of leading experts to produce this book, which is well referenced and its black and white figures nicely produced. The book is predominantly concerned with the role of stereotactic surgery for movement disorders and this subject is examined in depth. The book is divided into four parts. The first section recounts, in three chapters, the rationale for surgical therapy. The circuitry and physiology of the basal ganglia are reviewed along with the historical development of surgery for Parkinson’s disease.

    The second and main part of the book describes the surgical management of Parkinson’s disease and tremor patients, including patient selection and assessment, target selection and localisation, operative techniques, neuropsychological evaluation, and in situ programming of deep brain stimulators. This section also contains separate chapters on thalamotomy, pallidotomy, subthalamic nucleotomy, and deep brain stimulation of the thalamus, globus pallidus, and subthalamic nuclei. Within these chapters there is a rich diversity of opinion, which is one of the great strengths of this book and reflects this rapidly expanding field.

    The third section reviews the surgical treatment of focal and generalised dystonia. This is presently a very exciting field and the relevant chapters detail experience with thalamotomy, pallidotomy, and pallidal stimulation as well as the roles of intrathecal baclofen pumps and peripheral denervation procedures for managing dystonic patients.

    The final part of the book, labelled Miscellaneous, describes the use of PET for examining the changes in activity in the cerebral circuitry of movement disorder patients undergoing surgery. Finally, there is an account of the role of fetal transplantation and future surgical therapies for the treatment of Parkinson’s disease.

    This book provides the reader with considerable penetration into the rapidly expanding field of movement disorder surgery. I found it fascinating and informative. It has a place in the hospital or university neuroscience library and I particularly recommend it to neurologists, neuropsychologists, neurosurgeons, and research fellows who wish to have an overview and/or develop their interest in stereotactic surgery for movement disorders.

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