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Diagnosis and Management of Parkinson’s Disease
  1. ROGER BARKER

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    Diagnosis and Management of Parkinson’s Disease. Edited by cheryl h waters. (Pp 240, US$17.95). Published by Professional Communications, New York, 1998. ISBN 1-884735-33-9.

    This is a new pocket size handbook on Parkinson’s disease with 11 chapters covering all aspects of this disorder ranging from definition and classification to newer surgical therapies. It is well written and easy to read, although its format means that some of the pictures and figures are so small that they are difficult to interpret. However, the simple chapter layout and the marking out of them on the margins of the page does make it easy to use. The book makes good use of graphs and tables, although some of the tables are so overinclusive that it is hard to know their value in terms of what is rare and what is not.

    The text is concise and clear although there are controversial statements that I would take issue with—for example, the existence of paraneoplastic parkinsonism and the notion that the intralaminar nuclei of the thalamus are part of the basal ganglia. Conversely other controversial issues are not discussed and these include the cognitive aspects of early Parkinson’s disease, the priming effect of levodopa in the development of dyskinesias and thus the treatment of young onset Parkinson’s disease. Furthermore, the book rather overstates some of the trial data on various drug therapies which means that the best management of patients with Parkinson’s disease can sometimes be hard to extract. Indeed the book is clearly written for the American physician, and so there is essentially no mention of lisuride, apomorphine, or cabergoline whereas pramipexole has a very high profile and selegiline receives little adverse publicity. Furthermore, the classification of multisystem atrophy and the distinction between it and striatonigral degeneration, Shy-Drager and sporadic OPCA in the United States can be confusing. This emphasis obviously makes it harder to accommodate in the United Kingdom market, and the audience for which the book is attended, although neurologists in training, unable to afford the bigger movement disorder books, would probably find this book useful.

    However, as an easy to read, rapid guide to Parkinson’s disease, this is a useful addition not least because of its length and cost and its attempt to deal with all aspects of the disorder equally.

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