can be recommended strongly to anyone interested in the modern treatment of neoplastic diseases. This monograph presents a discussion of the current concepts of clinical and pathological classification of Hodgkin's disease, approaches to therapy and clinical management. Among the advantages of the presentation are the excellent compilations of the classifications of the disease and tabulations of results achieved to date with regard to therapy and survival. While the author has carefully reviewed the pertinent material, his comments and conclusions are inexplicable in many instances. Examples include the recommendation for radical surgery in early or focal disease. None of the surgical series is a randomized prospective study nor do the majority include an adequate number of cases for statistical validity to warrant the author's recommendation. In presenting Kaplan's results with radical radio-therapy, there is an excellent reproduction of data showing the superiority of radical versus conventional radiotherapy. The author comments nevertheless that conventional therapy is \"fairly satisfactory !\" The scheme for radiotherapy of Stage I is reasonable, but the method employed is not that of most centers utilizing the radical approach in this country. For Stage III disease the plan seems less comprehensible since it involves treatment of involved but not adjacent areas. If it is intended to be \"curative,\" there is inadequate therapy for adjacent areas. If it is intended to be palliative, it would be unnecessary to treat asymptomatic although involved areas. The discussion of chemotherapy consists of general comments regarding efficacy and toxicity without a well defined analysis of comparative responses derived from objective assessment. A few opinions are cited without data to support the claims. In presenting clinical problems in the management of the disease, there are references to the immunological studies of patients with Hodgkin's disease, but no description of the specific immunologic status. Extra-nodal Hodgkin's disease as a specific entity also appears to have been neglected. In summary, this monograph provides an interesting review of some advances in Hodgkin's disease. The quality of the presentation in terms of organization and conclusions could be improved. The diagnosis and proper understanding of neurologic disorders depend heavily on thorough knowledge of the structure of the nervous system, and of the relationships between structure and function. Dr. Brodal's work represents an authoritative exposition of these relationships. The present edition is a thorough revision of the original book, published in English in 1946. Comparison of the two volumes provides a …

Neurological Anatomy in Relation to Clinical Medicine

Evidence-Based Practice: Evaluation and Management of Unilateral Vocal Fold Paralysis

To revise the 2010 consensus guideline on chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Seventeen disease experts, a patient representative, and two Cochrane methodologists constructed 12 Population/Intervention/Comparison/Outcome (PICO) questions regarding diagnosis and treatment to guide the literature search. Data were extracted and summarized in GRADE summary of findings (for treatment PICOs) or evidence tables (for diagnostic PICOs). Statements were prepared according to the GRADE Evidence-to-Decision frameworks. Typical CIDP and CIDP variants were distinguished. The previous term "atypical CIDP" was replaced by "CIDP variants" because these are well characterized entities (multifocal, focal, distal, motor, or sensory CIDP). The levels of diagnostic certainty were reduced from three (definite, probable, possible CIDP) to only two (CIDP and possible CIDP), because the diagnostic accuracy of criteria for probable and definite CIDP did not significantly differ. Good Practice Points were formulated for supportive criteria and investigations to be considered to diagnose CIDP. The principal treatment recommendations were: (a) intravenous immunoglobulin (IVIg) or corticosteroids are strongly recommended as initial treatment in typical CIDP and CIDP variants; (b) plasma exchange is strongly recommended if IVIg and corticosteroids are ineffective; (c) IVIg should be considered as first-line treatment in motor CIDP (Good Practice Point); (d) for maintenance treatment, IVIg, subcutaneous immunoglobulin or corticosteroids are recommended; (e) if the maintenance dose of any of these is high, consider either combination treatments or adding an immunosuppressant or immunomodulatory drug (Good Practice Point); and (f) if pain is present, consider drugs against neuropathic pain and multidisciplinary management (Good Practice Point).

https://onlinelibrary.wiley.com/doi/epdf/10.1111/jns.12455

European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force-Second revision.

Psychiatric comorbidity in psychogenic nonepileptic seizures compared with epilepsy.

A novel methodology for assessing laryngeal and vagus nerve integrity in patients under general anesthesia.

Objectives/Hypothesis:

To analyze existing evidence regarding utility of laryngeal electromyography (LEMG) for prognosis in cases of vocal fold palsy (VFP).



Study Design:

Meta-analysis of studies reporting LEMG results and clinical outcomes in 503 patients with of VFP identified by literature search.



Methods:

Studies were identified by literature search. Method of diagnosis, interval to LEMG, criteria for prognostication, and outcome were assessed. Criteria for prognosis were standardized to the extent possible across all studies, and studies were checked for consistency in outcome measures and assessments. Pooled data were subjected to statistical analysis.



Results:

A total of 296/503 patients (58.8%) had findings predictive with poor prognosis, whereas 207/503 (41.2%) had findings of recovery. According to laryngoscopic examination, 269/296 patients with predicted poor recovery had poor recovery (positive predictive value = 90.9%), whereas 27/296 (9.1%) had good recovery. In patients with findings consistent with recovery, 115/207 (negative predictive value = 55.6%) noted return of motion, whereas 88/207 (44.4%) did not. The odds ratio was 11.56 with 95% confidence interval of 7.10-18.81.



Conclusions:

LEMG is a good predictor of poor recovery in patients with VFP and is clinically useful in identifying candidates for early definitive intervention.

Laryngeal electromyography for prognosis of vocal fold palsy: a meta-analysis.

To analyze existing evidence regarding utility of laryngeal electromyography (LEMG) for prognosis in cases of vocal fold palsy (VFP).

Laryngeal Electromyography for Prognosis of Vocal Fold Palsy

A comparison of personality disorder characteristics of patients with nonepileptic psychogenic pseudoseizures with those of patients with epilepsy.

Introduction The purpose of this study was to develop an evidence-based consensus statement regarding use of laryngeal electromyography (LEMG) for diagnosis and treatment of vocal fold paralysis after recurrent laryngeal neuropathy (RLN). Methods Two questions regarding LEMG were analyzed: (1) Does LEMG predict recovery in patients with acute unilateral or bilateral vocal fold paralysis? (2) Do LEMG findings change clinical management in these individuals? A systematic review was performed using American Academy of Neurology criteria for rating of diagnostic accuracy. Results Active voluntary motor unit potential recruitment and presence of polyphasic motor unit potentials within the first 6 months after lesion onset predicted recovery. Positive sharp waves and/or fibrillation potentials did not predict outcome. The presence of electrical synkinesis may decrease the likelihood of recovery, based on 1 published study. LEMG altered clinical management by changing the initial diagnosis from RLN in 48% of cases. Cricoarytenoid fixation and superior laryngeal neuropathy were the most common other diagnoses observed. Conclusions If prognostic information is required in a patient with vocal fold paralysis that is more than 4 weeks and less than 6 months in duration, then LEMG should be performed. LEMG may be performed to clarify treatment decisions for vocal fold immobility that is presumed to be caused by RLN. Muscle Nerve 53: 850-855, 2016.

Consensus statement: Using laryngeal electromyography for the diagnosis and treatment of vocal cord paralysis

MARY L. VO, MD, PharmD, ANELIYA HANINEVA, BS, RUSSELL L. CHIN, MD, BRIDGET T. CAREY, MD,NORMAN LATOV, MD, PhD, and JENNIFER A. LANGSDORF, MDPeripheral Neuropathy Center, Weill Cornell Medical Center, 1305 York Avenue, Second Floor, New York, New York 10021, USAAccepted 8 August 2014ABSTRACT: Introduction: European Federation of NeurologicalSocieties/Peripheral Nerve Society electrodiagnostic (EDx) cri-teria for the definite diagnosis of chronic inflammatory demyeli-nating polyneuropathy (CIDP) require the presence ofdemyelinating findings (DF) in at least 2 nerves. Data are lack-ing, however, regarding the optimal number of nerves to test.Methods: We retrospectively reviewed EDx data from 53patients with CIDP and compared the number of DF found on2- and 3-limb testing. Results: A median of 3 (range 2–5) DFwere found on 2-limb testing compared with 5 (range 4–7) DFwhen 3 limbs were evaluated. Two-limb EDx studies were suffi-cient to diagnose definite CIDP in 92.3% of typical, 84.2% ofasymmetric, and 66.7% of distal phenotypes. Testing a thirdlimb increased diagnostic certainty in 11 patients (20.8%) todefinite CIDP. Conclusions: Three-limb testing may increasediagnostic sensitivity of definite CIDP, especially in patients withatypical phenotypes. Larger prospective studies are needed tobetter assess the benefit of performing 3-limb EDx studies.

Bridget T. Carey

Papers

Laryngeal electromyography for prognosis of vocal fold palsy: a meta-analysis.

Laryngeal Electromyography for Prognosis of Vocal Fold Palsy

A comparison of personality disorder characteristics of patients with nonepileptic psychogenic pseudoseizures with those of patients with epilepsy.

Consensus statement: Using laryngeal electromyography for the diagnosis and treatment of vocal cord paralysis

Comparison of 2‐limb versus 3‐limb electrodiagnostic studies in the evaluation of chronic inflammatory demyelinating polyneuropathy