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Clinical neurology
  1. Ian Bone

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    By David Greenberg, Michael Aminof, and Roger Simon (Pp 390 $39.95). McGraw-Hill Professional, New York, 2002. ISBN 0-07-137543-0

    Reviewing an undergraduate text is always quite a difficult task in that one has to approach one's speciality again through fresh and innocent eyes asking the simple question, would I recommend this? The book, in its fifth edition, claims to present a “problem oriented approach” that has been founded on the authors' experience in teaching both undergraduate students and junior medical staff at the University of California (San Francisco). The changeover in our own universities to this teaching approach made me believe that this would be a particularly enlightening and instructive read. I was especially interested to see how the presentation of basic essential knowledge (neuroanatomy, physiology, molecular pathogenesis) fitted into such a schema. I am afraid, in the end, that I was disappointed to find the book not dissimilar to the majority of recommended “standard” undergraduate texts. While each chapter follows the similar template of an initial approach to diagnosis, what follows is variable and not what I would regard as problem oriented. For example, while the section on headache does list modes of presentation (acute, subacute, and chronic), other chapters, such as “Disorders of somatic sensation” or “Motor deficits”, present the usual long lists of conditions without balance (what is common and what is rare), encouraging a logical approach to symptom interpretation or developing an appropriate investigative pathway. The book does have its good points in that it is comprehensive with well defined key concepts at the beginning of each section and a comprehensive lists of references at the end but the therapeutics are patchy, the glossary of frequently used drugs unhelpful, and the account of neurological investigations inadequate. I would not recommend this as an addition to our current undergraduate reading list, as there are better texts available.

    While any text entering its fifth edition has proved its worth to many and clearly serves the students of San Francisco well, a true problem oriented text has failed to emerge from the fog around the Bay! A modern text to supplement our new and evolving approach to the undergraduate teaching of clinical neurology remains a challenging agenda.

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