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Prognosis in Neurology.

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    Prognosis in Neurology. By james m gilchrist. (Pp384, £55.00). Published by Butterworth Heinemann, Oxford, 1998. ISBN 0 7506 9888.

    This book is an attempt to rectify the gulf that has developed between the emphasis that has been placed on diagnosis in contemporary neurology and the pastoral care that has traditionally comprised a large proportion of a neurologist’s clinical practice. It is designed as an accessible guide to prognosis in neurological disorders for both senior and junior clinicians and benefits from the contributions of nearly 100 authors. The usefulness of this book relies on the basic premise that the diagnosis has been established and is accurate, it leaves no room for manoeuvre on the grey cases with which we are all so familiar.

    The chapters are short and necessarily concise, attempting as it does to cover the whole range of neurological disease. For example cerebral stroke is covered in three pages and spondylosis in a little less; multiple sclerosis and CNS lyphoma are given the same exposure. As the price of this book is £55 the fundamental question when the impoverished SpR is deciding on the direction his educational funds should take is whether this book has substantially more to offer than is available in one of the more comprehensive general textbooks of neurology. On balance I think it does but its forte is clearly the more unusual diseases rather than stroke, multiple sclerosis, and dementia. The manner in which the chapters are set out with stereotyped headings of natural history, factors affecting prognosis, evaluation for prognosis, therapies affecting prognosis, short term prognosis, and long term. prognosis allow quick and easy reference and retrieval of information.

    Not an essential book, but it teaches us the importance of prognostic features in neurological disease and is likely to be a useful companion to have for interviews with patients and their relatives who are understandably willing recipients of this information.

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