Although recognised for more than 100 years, central pain remains ill-defined, poorly understood, intensely debilitating and, in the majority of patients, refractory to therapy. In this text, Professor Pagni attempts to define, classify, and review critically the multitude of treatments that have been proposed for this most challenging of conditions.

The book begins with a review of the history of the condition and a discussion of its definition, nosology, and clinical spectrum. There follows a survey of the lesions which cause central pain, both spontaneous and iatrogenic, theories about its aetiology, and the various measures available to treat it. There is an extensive bibliography for further reading.

The book provides a critical review of the literature on central pain, interspersed with personal observations from over 30 years of experience in the field. It is written in a succinct style that presents theories and therapies in a historical sequence, followed by the author’s comments on current indications and clinical outcomes. If I have one criticism of this book it is the index, which is by subject heading rather than strictly alphabetical sequence, making it cumbersome for cross-referencing. This, however, is a minor irritation.

In summary, this is a thoughtful and enjoyable book. It takes a logical look at a subject which, by its very nature, has a literature containing many anecdotal reports that can be hard to evaluate in isolation.