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Mechanism and management of headache, seventh edition
  1. E Loder

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    Edited by James W Kance, Peter J Goadsby. Published by Elsevier, Philadelphia, 2005, £34.99 (hardback), pp 392. ISBN 0-7506-7530-6

    As a general rule, it is safe to assume that any textbook entering a seventh edition does so on its merits and must be worth reading. The latest edition of the classic Mechanism and Management of Headache by Lance and Goadsby does not disappoint. It is occasioned not just by the passage of time but also by advances in the field of headache that make a new edition necessary. Among these, the long-awaited revision of the International Classification of Headache Disorders is the most important, as it has created some entirely new headache entities and significantly altered criteria for others.1 New information about the structural consequences of seemingly benign headache disorders – iron deposition in the brainstem, an increased prevalence of clinically silent ischaemic brain lesions in migraineurs, for example – and impressive gains in understanding of the basic pathophysiology of headache also demand explication for practising physicians. So too do new “hot topics” such as the possible connection between patent foramen ovale and aura, or the use of nerve stimulators to treat various forms of headache. And finally, the treatment landscape for many headache disorders, notably migraine, has changed considerably since publication of the sixth edition: new triptans, the advent of topiramate for prophylaxis, the increasing popularity of pre-emptive treatments for menstrual migraine, to name just a few.

    Readers who turn to this book for up to the minute information about the pathophysiology of headache, research advances, and the latest treatment recommendations will find it all here, as the book has been thoroughly and thoughtfully updated. That this has been done without sacrificing the time-tested features of the previous editions is a credit to the authors and editors. In particular, the delightful, personable voice of Dr Lance remains recognisable in many of the chapters, especially those dealing with the general approach to the patient, while Dr Goadsby’s scientific authority shows plainly in chapters dealing with pathophysiology. Dr Lance’s preface to the first edition has been retained, and is a delight to read: the good natured, sensible, still-relevant advice of a master clinician. Readers should take note of the impressive, ever-expanding list of scientific collaborators and scholarly heirs to the incredibly productive Lance-Goadsby headache dynasty. With the publication of this edition, the list has expanded from 35 to 53, and contains the names of many of headache’s best and brightest. There is no better testament to the enduring legacy and influence of both authors.

    The new edition is slightly smaller than the previous one, and the cover design has been updated. Those are cosmetic changes only, but appreciated nonetheless. Chapter titles and order have not been changed, save for the welcome insertion of a new chapter on chronic daily headache. The book begins with an historical overview of headache that serves as a useful reminder of just how far we have come from the days when holes were drilled in the skull to relieve headache. Throughout the book, photographs have been updated or replaced, and in general are clearer than those in previous editions. Horner’s syndrome, third nerve palsy, and other physical findings are nicely and usefully illustrated, and are a true asset to the chapter on examination.

    Not unexpectedly, the chapters dealing with headache classification and pathophysiology have undergone the most extensive revision. Updated, timely information about natural treatments has also been added, reflecting the reality of patient interest and enthusiasm for such things. A new table on clinical stratification of acute, specific migraine therapies has been added to the treatment chapter, and other tables in this chapter are more carefully organised, larger, and more readable than those in previous editions. A small oversight is the retention of the older term “tension headache” in many places – perhaps done to save space, but if so at the expense of the subtle but important implications conveyed by the longer term “tension-type.”

    Edited by James W Kance, Peter J Goadsby. Published by Elsevier, Philadelphia, 2005, £34.99 (hardback), pp 392. ISBN 0-7506-7530-6

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