Epilepsy, Behaviour and Cognitive Function

problems in addition to the signs of the Wernicke-Korsakoff syndrome.Many of the patients were closely examined over long periods and the authors make the point that repeated examinations for as long as ten years in some instances allowed them to describe the natural history of the syndrome.and this they do in their third chapter.Again the description of the pathological findings is precise and comprehensive and the authors stress the periventricular dis- tribution of the lesions and their bilateral symmetry.The authors consider specifically the neuropathological substrate on which are based the defective memory, ocular motor signs, the ataxia, the global con- fusional state and the occasional disturbance of olfactory and gustatory function.They argue a unity between Wernicke's disease and Korsakoff's psychosis and discuss the relationship between these two and alcoholic cerebellar degeneration, central pontine myelinolysis and other myelinolytic syn- dromes and interestingly discuss the problem of "alcoholic dementia" concluding that the nosological status ofalcoholic dementia is by no means proved.They believe the majority of so-called "alcoholic dementia" patients have suffered Wernicke-Korsakoff syn- drome with lack of recognition of the clinical features during life.The post-mortem find- ings together with various traumatic lesions of the nervous system, related or unrelated to alcoholism, confuse the picture.They con- clude that there is no need to invoke a separate entity due to the toxic effect of alcohol on the brain.Typically they write that despite their comprehensive and auth- oritative monograph "there is still a great need for careful pathological examination of cases that have received thorough clinical and psychological examination".This volume considerably enhances the already high standard of the Contemporary Neurology series.JB FOSTER Medical Therapy of Acute Stroke.Edited by Mark Fisher.(Pp 294; $69.75 US and Can- ada, $83.50 all other Countries.)