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Dr Lawrence Robbins, from Rush Medical College, Chicago has revised his deservedly popular 1994 text on the management of idiopathic headache syndromes. He shares a wealth of clinical experience in the drug therapy of difficult headache patients, with necessarily brief descriptions of clinical features and pathogenesis. Although there is an extensive list of references at the end of the book, they are not cited directly in the text, and the book reads as one man's recipe book rather than a systematic review of published trials, or of the pharmacological or clinical evidence supporting management decisions. It is inevitable that the range of drugs recommended is American, with more emphasis on narcotic and barbiturate combinations and no mention of domperidone or pizotifen, but there is a useful glossary of United States trade names as an appendix.
The chapters on the acute and preventative management of migraine, tension headache, and cluster headache are followed by illustrative case histories, from which it is soon apparent that the tendency of United States patients to see many neurologists and complain more about side effects can lead to the use of an extremely wide range of drugs, sometimes making one's own multiple efforts on behalf of a challenging tertiary referral seem straightforward by comparison. There is a particularly useful chapter on headache in patients aged over 50, post-traumatic headache, lumbar puncture headache, chronic paroxysmal hemicrania, and SUNCT.
Although filled with much clinical wisdom from a vastly experienced author, the book has the feel of a catalogue; for European readers it is more likely to have a role as a desktop reference text.
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