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I bought the first edition of this popular book in 1989, shortly after it was published. I dipped into it enthusiastically for a few months, even scribbling some notes in the margins. However, since 1990 it has been unopened. The reason for this neglect is not its content, but rather its presentation. The dense text is relieved by few illustrations and the paragraph headings are too uniform in style to easily understand the chapter structure. These may be superficial criticisms, but they are sufficient to blunt success in the highly competitive market place of neurology text books for students and junior doctors.
This second edition could not be more different. It is beautifully organised. From the original text, clinical bon mots have been highlighted and long paragraphs have been broken up in to plain and boxed text. The introductory chapter on examination of the nervous system is particularly helpful; for instance, Marsden distinguishes between hard and soft neurological signs and describes how to deal with conflicts between them. The scope is wide, including chapters on paediatric neurology and the neurology of general medical disorders, psychiatry, and neurorehabilitation. There is plenty for the Gower’s Round hack too: the differential diagnosis of progressive myoclonic ataxia, the subtypes of neuronal ceroid lipofuscinoses, and such favourites. All these were there in the first edition but, at least to my taste, hard to access. For the first time ever, I find myself preferring a sequel.
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