Physical Medicine and Rehabilitation: Clinical Electrophysiology.

Physical Medicine and Rehabilitation: Clinical Electrophysiology Edited by Dumitru D. Philadelphia, PA 19107, Hanley & Belfus Inc, 1989, hardcover, 180 pp, illus, $29 This particular volume of State of the Art Reviews in Physical Medicine and Rebabilitation focuses on clinical electrophysiology. Each chapter provides an update of pertinent electrophysiologic topics that are clinically relevant to electromyographers. Topics covered in the book include motor and sensory responses of the peripheral nervous system, needle electromyography (EMG), and somatosensory evoked potentials. The text is divided into three sections. The first section consists of two chapters written by the editor of the book. The information in these two chapters, on volume conduction and the fundamentals of neurophysiology and electrophysiologic instrumentation, is presented in a comprehensive and clinically applicable manner. The effect of volume conduction and instrumentation settings on motor and sensory responses, needle EMG, and somatosensory evoked potentials is described in detail. The second section, which consists of eight chapters, provides material on a wide range of motor and sensory and needle electromyographic findings related to anterior horn cell pathophysiology, radiculopathies, plexopathies, entrapment neuropathies, myopathies, neuromuscular junction disorders, and pediatric electrophysiologic assessment. The chapters are clear, concise, well-written, and appropriately referenced with current literature citations. These chapters provide a thorough overview of the clinical situations most often encountered by general practice electromyographers; however, the chapter on electrodiagnosis in sports medicine is somewhat disappointing, as it presents information on cervical radiculopathies but nothing on other sports-related nerve injuries of the lumbar spine, lower extremities, and upper extremities. The third section consists of a chapter by Spielholz, which updates the current methodology and controversies regarding the use of intraoperative somatosensory evoked potentials. Spielholz presents in detail false-positive and false-negative results, as well as determining test sensitivity and specificity of somatosensory techniques. This chapter is especially noteworthy for its clarity and clinical relevance. Experienced electromyographers will find this book useful as a review and update of pertinent topics in clinical electrophysiology. Physical therapists, physical therapy students, graduate students, and interested nonelectromyographers can learn through the book how electrophysiologic testing helps formulate an accurate assessment of nerve injuries. David E Nestor