Brain, Vol. 125, No. 11, 2579,
November 2002
© 2002 Oxford University Press
Book Review |
ADAMS AND VICTOR’S MANUAL OF NEUROLOGY, 7TH EDITION
Department of Neurology, Royal Free Hospital, London, UK
ADAMS AND VICTOR’S MANUAL OF NEUROLOGY, 7TH EDITION
By Maurice Victor and Allan H. Ropper
2002. New York: The McGraw–Hill Companies
Price £29.99. ISBN 0071373519.
The back cover of this paperback pocket volume describes it as ‘a clinical manual referenced to the leading neurology text in the field’. While there may now be other contenders for that title, Adams and Victor’s Principles of Neurology has been, and remains, a wonderful source of authority and wisdom for generations of neurologists and other physicians in the US and worldwide. The purpose of the manual, or ‘little book’ as the late Dr Maurice Victor affectionately termed it, is to be a portable companion to the major text, bringing its wisdom to the bedside and outpatient department in an easily accessible form. In so doing, it retains the logic and pattern of the larger book, which in turn reflects that of Harrison’s Principles of Internal Medicine, which Dr Raymond Adams co-edited for so many years. Thus, the manual begins with the clinical approach to a patient with neurological disease and the cardinal manifestations of such diseases (disorders of motility, sensation, consciousness and so forth). After an intervening section on growth, development and ageing of the nervous system, the remainder of the book covers the main categories of neurological disease (neoplastic, infective, vascular, traumatic, demyelinating, metabolic, developmental and degenerative). There is a separate section on diseases of peripheral nerve and muscle and a concluding part on psychiatric disorders.
As might be expected from its provenance and authorship, this latest edition of the Manual of Neurology is a model of clarity and fluency. Despite its brevity compared to Principles of Neurology, it still contains a wealth of information, much more than that required at undergraduate level. Presumably, its intended readership primarily comprises postgraduate neurology students, specialist trainees and busy clinicians needing a quick reference source. Such an audience would have no difficulty with the style, which remains expansive, even in this pocket volume. However, a plea could be made for more figures and tables as there are still many pages of unbroken text. Those figures which do appear are occasionally rather arcane. Thus, for example, a busy intern is unlikely to need a diagram of the cerebellum which labels such exotic structures as the culmen and declive. Similarly, some of the tables are very long. Those listing causes of symptoms or syndromes could be rendered easier to digest by being passed through the familiar ‘surgical sieve’—inherited, traumatic, inflammatory, etc.
Regarding content, there are few quibbles. A neuropsychological purist might prefer a more robust definition of dementia than that given in Chapter 21. Similarly, those with an interest in neurogenetics might occasionally feel short-changed. This applies particularly to the discussion of the genetics of multiple sclerosis and to the somewhat antiquated classification of the cerebellar ataxias, which does not refer to the SCA mutations. Minor factual and typographical errors are few, as might be anticipated in a book which has gone through so many refinements, but the authors probably intended to say ‘segmental demyelination’ not ‘segmental degeneration’ in the first paragraph on pathological reactions of peripheral nerve (p. 422). Each chapter concludes with an additional reading list which sometimes lacks current references.
But these minor concerns seem a small price to pay for a book which represents the distillation of a lifetime of clinical experience from three doyens of neurology. The question for Dr Ropper, as sole remaining active author, is the future of Manual of Neurology and indeed of its parent, Principles of Neurology. Someone (probably a neurologist) once pointed out that there are more diagnoses in our speciality than in the whole of the rest of medicine put together. Paradoxically, this breadth and complexity, which was instrumental in generating the successful format of Adams and Victor, may make it difficult to continue to produce editions with just one or two authors. Other classic neurological texts which began as single-author works, such as Brain’s Diseases of the Nervous System, have now succumbed to multi-author editions. Dr Ropper will no doubt be exercised by the conflict between soldiering on alone, with its advantages of greater cohesion and lack of repetition, and enlisting multiple co-authors to do justice to all the branches of our subject, in the face of ever expanding neurological knowledge.
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