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This book is divided into three sections: migraine; other primary headaches; and secondary headaches. The pathophysiology of migraine is covered with clarity, although I doubt if I will ever quite come to grips with 14 different serotonin receptors. Symptomatic and prophylactic treatments of migraine are considered in detail with up to date coverage of available treatments and mention of drugs in development. Many women comment on the effect of menstruation on their migraine and one chapter tries to put this into pathophysiological perspective and suggests modes of treatment. There is also a useful description of some of the rarer idiopathic headaches.
The authors state that “tension type headache has in the past been an ill defined syndrome”. Unfortunately, little in the ensuing pages suggests a major change in its status and the classification of chronic daily headache remains problematic. Some recognisable syndromes are described such as analgesic associated headache. In the chapter on tumours, the authors discuss the evidence surrounding the vexing question of when to scan and when not to scan. Other secondary headaches considered involve the temporomandibular joint, the neck, and painful ophthalmoplegia, topics rarely covered elsewhere. This section is generally well illustrated with scans and the basic science section has graphs and diagrams covering salient points.
The text is well referenced and the authors bring a strong critical appraisal to each topic. The result is a book that seems to be authoritative in breadth and depth, is securely grounded in clinical and scientific research, and has a coherent structure. It should prove to be invaluable to the jobbing neurologist, for whom headaches are bread and low fat spread.