Clinical Neurology; Graeme J. Hankey, MBBS, MD, FRCP (Lond), FRCP (Edin), FRACP, Joanna M. Wardlaw, MBChB, MD, FRCP, FRCR Demos Medical Publishers, New York, 2003. ISBN: 1-888-799-67-6, $195.00
Scope: This is an encyclopedic reference of neurologic entities formulated to help generate a useful and reasonable differential diagnosis and establish guidelines for the evaluation of the patient with neurologic dysfunction.
Contents: The format is concise, mainly in outline form, with bulleted lists. The text is well-illustrated, with more than 800 color plates, neuroradiologic images, graphs, and charts. The first chapter is a concise discussion of the tools of neurologic diagnosis with special attention to the history, neurologic examination, imaging modalities, and examination of the cerebrospinal fluid. Ancillary tests such as EEG, nerve conduction and EMG studies, and evoked potentials are also included. The next several chapters are organized by phenomenology and discuss disorders of consciousness, epilepsy, headache, vertigo, and movement disorders. The next section is organized by pathophysiology, and considers developmental disorders, inherited metabolic disorders, central nervous system trauma, vascular abnormalities, infection, inflammation, tumors, degenerative disorders, acquired metabolic disorders, nutritional deficiencies, and disorders of cerebrospinal fluid circulation. The final chapters are organized by anatomy and consider the cranial neuropathies, spinal cord diseases, autonomic disorders, peripheral nerve disorders, mononeuropathies, neuromuscular junction abnormalities, and muscle diseases.
With a clinical problem in mind, the clinician can find the disorder in its category and simply review possible differential diagnoses. Each topic is presented in a standardized format, with bold-faced headings, definition, epidemiology, etiology, pathophysiology, and clinical features. Unusual aspects of clinical disease and suggestions for appropriate investigations are included. Each chapter includes timely and helpful references for further reading.
Strengths: Topics are easily located and helpful advice well-summarized. The format of the book offers practical suggestions for work-up and differential diagnosis with wonderful illustrations.
Weaknesses: Some entities are discussed too briefly, others not at all. For example, there is only the briefest discussion of delirium. There is little about abnormal and paroxysmal neurologic experiences such as hallucinations during the waking state. Sleep disorders are not considered. Not enough attention is given to immune-mediated or paraneoplastic disorders.
Recommended audience: This book will be most useful to the clinician without great experience or training in neurology. As such, it might be especially valuable to neuro-ophthalmologists trained primarily in ophthalmology. It should also be helpful to students and residents in both disciplines. It is a fine teaching tool with excellent illustrations and concise text.
Critical appraisal: This is a useful book for the clinician, the student, and the teacher in neurology and neuro-ophthalmology.
Shelley A. Cross, MD
Mayo Clinic; Rochester, Minnesota