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Over the past few years, increasingly well designed basic neurology textbooks have come on to the market, their attractive layout and quality illustrations serving to liberate today's students from the challenge of reams of unappetising text interrupted only by an occasional line drawing. The latest Lecture Notes in Neurology is one of this cohort and, as with several of its contemporaries, it now has several editions behind it; the previous incarnation (now over 12 years old) had long since fallen out of favour with its customers, showing clear signs of being rather “long in the tooth” in the face of fierce competition and a rapidly evolving specialty. On these grounds alone an update was long overdue, and the current guise (the seventh edition) has duly been substantially reworked; its new author has, however, not only brought along up to date knowledge, but has also imbued the text of this edition with a welcome clarity, coherence, and attention to detail. The overall layout meanwhile has also been modernised, with intelligent use of tables, figures, and text boxes alongside useful illustrations (mostly radiological).
The book is organised into two basic sections, the first of which takes on the neurological approach, and includes six chapters which partition the neurological examination into logical chunks. These are preceded by a short chapter on neurological history taking, which emphasises the rationale of the neurological approach to diagnosis, with a chapter on neurological investigations rounding off the section. Within each chapter the text is supported by clear illustrations that illuminate examination techniques and highlight important anatomical points. The second and larger section deals systematically with the so called neurological disorders. Among these, common conditions—for example, multiple sclerosis, epilepsy, stroke—warrant their own individual chapters, whereas other conditions are intuitively grouped either by their anatomical basis or by their aetiology—for example, spinal conditions, nerve and muscle, and neurological infections. Three diverse chapters complete this section, on neurology and other medical specialties, neurological emergencies, and neurorehabilitation.
The text layout is clear throughout, the diagrams straightforward and useful, and many text boxes (de rigeur in current publications) make light work of the inevitable lists (causes, syndromes, treatments, etc). Each chapter covers its topic(s) logically, with variations on a basic format of aetiology, epidemiology, clinical features, diagnosis, and management; and each is also tidily rounded off with a summary of important key points —with text again neatly boxed. Minor gripes exist: one or two of the tables are a little awkward—for example, the categorisation of the epilepsies—and one or two of the chapters are perhaps a little light on detail; however, in a book aimed at an undergraduate audience, some such compromises are probably unavoidable. The compromises are particularly obvious in the chapter on neurology and other medical specialties where, with so much ground to cover, the text loses its rhythm somewhat and becomes inevitably fragmented. Overall, however, the feeling is of a carefully thought out and well written book with, in most chapters, the balance between lucid explanation and more comprehensive detail being well maintained. Overall too, the logic of the assessment/disorder split is satisfying, as it facilitates access to the essence of what can seem to be a bewildering and unapproachable volume of knowledge and expertise. In the days of “core curriculae“ the book seems to have succeeded in encompassing enough core detail to be a truly useful foundation for neurological assessment, while retaining the necessary clarity and approachability that is so important in fostering an interest in the specialty.
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