Phantoms in the Brain

V S Ramachandran and Sandra Blakeslee
Fourth Estate, 1999; £8.99
ISBN 1857028953
Rating: 3/4

Professor Ramachandran is billed as one of the world's leading neuroscientists. His book is intended to be accessible to a lay audience, and cases from it have recently been seen in a television series. His subject is clearly of interest to medical students. Ramachandran presents bizarre cases of neurological problems where brain dysfunction has resulted in strange symptoms.

Examples include the impressively titled somatoparaphrenia, a syndrome where the patients deny that part of their body belongs to them. Asked, "Whose is that arm?" they reply, "It's my brother's." The Kluver-Bucy syndrome, resulting from temporal lobe damage, produces a lack of discrimination over what is eaten and what is approached sexually.

Ramachandran contrasts with Oliver Sacks. Where Sacks describes his patients' symptoms sympathetically, Ramachandran presents his with all the flair of a circus ringmaster. He then details ingenious and sometimes apparently cruel experiments with these patients to determine "what precisely is going on." Ramachandran also often attempts to explain his findings with little reference to theory. It is not always clear what is accepted and what is mere speculation, especially if you find it tedious to refer constantly to the numerous endnotes.

This book does not take itself seriously at all. Now, that's not all bad: the writing is easy to read and digest and you do not need to be a brain surgeon to enjoy it. But sometimes - for example, when extending a theory on the mechanism behind phantom limbs to foot fetishes - it goes too far.

Ramachandran delivers a whistlestop tour of some of the more bizarre syndromes resulting from brain injury. He covers many areas that arise in a neuroscience component of a medicine course, including the better known cases. For example, there is HM, who was cured of epilepsy by chopping out his temporal lobes, producing permanent anterograde amnesia. And Phineas Gage, who turned nasty after losing his frontal lobes to a tamping iron, gets a mention as well. Ramachandran proposes explanations for syndromes in terms of neuroanatomy and offers a decent reference and bibliography section, providing the opportunity to chase up interesting theories and findings. The book is easy reading and good fun. Sally-Ann S Price BSc intercalated psychology

Sally-Ann S Price, BSc intercalated psychology student, University of Leeds
Email: Ugm6sasp@leeds.ac.uk


studentBMJ 2000;08:347-394 October ISSN 0966-6494