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Fifty Neurological Cases from the National Hospital.

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    Fifty Neurological Cases from the National Hospital. By adrian wills and c david marsden. (Pp 184, £24.95). Published by Martin Dunitz, London, 1999. ISBN 1-85317-677-X.

    One of the most challenging parts of neurology is being able to give a coherent account of a case when presented with just the history and examination. This becomes all the more challenging when the exercise is witnessed by learned professors, less learned colleagues, and a cast of thousands—and thus was born the Gowers round at the National Hospital, Queen Square, London. The game as a training registrar at this centre of excellence was to try to put the case together while not making a fool of oneself. All well and good until the “very familiar well known syndrome” turns up and you are the only one in the auditorium apparently not in the know —how those knowing head nods from the front row would irritate at such times! Nevertheless, as a way of learning it is hard to beat, and many will cherish their battles at the Gowers round to the end of their day—which for many was thought to be the day of battle itself. Adrian Wills has now taken some of these cases and presented them as short case histories, with commentaries from leading authorities on the diagnosis. Indeed, many of us who had the privilege to train with Dr Wills will recognise many of the cases, I certainly came across one or two that I personally had presented. However, the approach adopted by this book is a useful exercise given the quality of cases that such a round boasts, although it is very different from the Gowers round; for a start the patients have a diagnosis! For another the challenge was to formulate an approach to the general problem being presented and then to dissect the differential diagnosis. This book does not enter into differential diagnoses, which thus undermines its value in my mind. However, for those in training who like to solve written case histories then this book is useful, and certainly the range of cases is interesting and varied and overall I must say I really enjoyed reading it.

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