Localization in Clinical Neurology, Fourth Edition; Paul W. Brazis, Joseph C. Masdeu, and José Biller. Lippincott Williams & Wilkins, Philadelphia, 2001. ISBN 0-7817-2843-6, $139.00
Scope: This multi-authored text presents clinical principles of neurologic localization. It represents the fourth edition of what has become the standard readable reference on this topic. It offers the advantages of many authors and takes advantage of the strengths of each; a standardized chapter format renders the whole quite seamless. The intended audience includes students and clinicians involved in the evaluation of patients with neurologic signs and symptoms.
The text is divided into 22 chapters divided primarily on a neuroanatomic basis (peripheral nerves, spinal cord, oculomotor systems, brainstem) with additional chapters on general principles of localization, vascular syndromes, and coma. Chapters generally begin with a concise and illustrated review of the relevant anatomy. Black and white cartoons provide a memorable anatomic picture of key relationships. The anatomy is dealt with in a clinically useful manner rather than the dry context often found in pure neuroanatomy texts. After anatomic background, chapters discuss the pathophysiology of lesions within each topic-based chapter. The book does not include treatments, and so its "shelf life" endures.
Strengths: This well-written text covers important clinical concepts in a manner not otherwise available. The writing style is concise and quite readable; the organizational format is presented in a useful context. The book benefits from a practical, clinically driven approach to neuroanatomy, subdivided according to relevant pathologic processes. Neuro-ophthalmologists will especially appreciate the outstanding and detailed coverage of the ocular motor system, visual pathways and cranial nerves, which comprise fully one-third of the text. The superb use of illustrations serves the purpose of highlighting key anatomic relationships. This book even makes the brachial plexus comprehensible.
Weaknesses: The book lacks noteworthy weaknesses! Future editions might integrate magnetic resonance imaging and computed tomography examples of anatomy and pathology to enhance the otherwise exceptional illustrations.
Recommended audience: This text should be compulsory reading for every neurology and neurosurgical house officer and is recommended for any student with a clinical interest in neurology. The book is an excellent reference for any "front-line" clinician confronted with neurology cases; it also serves as a valuable teaching tool for those involved in medical education.
Critical appraisal: This text has become the gold standard in localizational neurology and a must-read for all neurology house officers. It is a lifeline to those on neurology wards and anyone preparing for neurology board examinations.
Eric R. Eggenberger, DO
Departments of Neurology and Ophthalmology; Michigan State University; East Lansing, Michigan