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Book Review

Practical Neurology, 4th ed

Howard S. Kirshner, MD

Published: April 15, 2014

Practical Neurology, 4th ed

edited by José Biller, MD. Wolters Kluwer Health, Lippincott Williams & Wilkins, Philadelphia, Pennsylvania, 2012, 747 pages, $102.99 (paper, with color chart included).

Practical Neurology is a comprehensive textbook, over 700 pages long, but written in an abbreviated, almost outline format. It is available in paperback, and it represents the fourth edition of this popular textbook. Dr Biller, currently at Loyola of Chicago, formerly Chairman of Neurology at the University of Indiana, is a well known neurologist and educator. Practical Neurology contains chapters on all of the major neurologic disorders, written by a large number of recognized experts in their fields. The style of the book is remarkably uniform considering the many authors of the individual chapters.

The book is rather dense for reading sequentially, especially because of its outline format, but it contains a remarkable amount of detailed information. It is divided into 2 major sections, the first on Diagnosis, or the approach to the patient with specific complaints, the second on Treatment, including all of the major categories of neurologic diseases. When I looked for topics that I suspected might be missing, I rarely found them.

If I had to cite one major flaw, it would be that many of the references are relatively old and some current references are missing. For example, the ethics chapter mentions older landmark legal cases, but not the Terri Schiavo case, and the stroke chapter discusses cholesterol treatment but does not include the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) trial, the main source of evidence for the recommendation of statin therapy in stroke patients. I found the dementia chapter rather short, given the avalanche of new information and clinical trials in this disease category. This is not the reference work for psychiatrists to read about the latest clinical trials in Alzheimer’s disease or frontotemporal dementia. The stroke chapter did not do justice to the development of acute treatments for ischemic stroke, notably the new clot retrieval devices, and the evidence for their efficacy. I found only a few errors, for example referring to Lyme disease (named for Lyme, Connecticut) as "Lyme’s disease." The headache chapter had an alphabet soup of abbreviations, some not explained, such as "CM" (p 583), which I suspect stands for chronic migraine; MOH (p 584), which I suspect refers to medication overuse headache; and CTTH (p 584), defined earlier in the chapter as chronic tension type headache. Such plentiful abbreviations, combined with the outline format, make this book somewhat difficult to read.

My overall recommendation of the book would be that it is worth having available to look up information on neurologic disorders by practitioners who are learning neurology or who practice related specialties such as psychiatry. The book is very readable, though densely written. It is light enough to carry on rounds or to have available in the hospital or office, yet it contains a wealth of information for retrieving detailed material about neurologic diseases, including treatment recommendations, doses of drugs, and relevant references. Overall, the book has a remarkable amount of useful information for such a relatively light volume. I would absolutely recommend obtaining a copy as a reference book, but I cannot recommend reading it cover to cover, as I attempted to do.

Howard S. Kirshner, MD

Author affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee.

Potential conflicts of interest: None reported.

Volume: 75

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