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Pocket Companion to Neurology in Clinical Practice. Second Edition.

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    Pocket Companion to Neurology in Clinical Practice. Second Edition. Edited by bradley, daroff, fenichel, and marsden(Pp758; price £35.00). Oxford: Butterworth Heinemann, 1996. ISBN 0 7506 9787 3.

    What is the point of these pocket companions in neurology? There are certainly plenty of them: either distillations of authoritative textbooks (such as this and the companion to Victor and Adams) or culled from residency teaching programmes (for example, TheLittle Black Book of Neurology produced from Robert Daroff’s department). The “salient points of clinical diagnosis and management—those most useful at the bedside” have been extracted from Bradley, Daroff, Fenichel, and Marsden’s two volume textbook. Does this mean we get earthy advice from grizzled neurological veterans? Well, not really. Emergency treatments are reasonably covered. But this book will not transform your difficult clinics. If you wondered about treating insomnia, all you will learn is that management should be “individually designed dependent on the causative factors”. As much space is devoted to the treatment of the Lambert-Eaton myasthenic syndrome as to the symptomatic management of multiple sclerosis; more to Lesch-Nyhan disease than to tension headache. Here is a clue to the real purpose of these little books. They are to be pulled out in those quiet moments to indulge in that most neurological of activities, the pursuit of the arcane. There are excellent chapters on the neurocutaneous disorders and inborn errors of metabolism. There are three good pages on the mucopotysaccharidoses and a cracking appendix on neurogenetics. What does it matter that not one clinical trial in the management of stroke, carotid stenosis, Guillain-Barré syndrome, or CIDP is mentioned?

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