Illustrated neurology

Illustrated neurology

In Context Book Neuroepidemiology not only for neuroepidemiologists Handbook of Clinical Neuroepidemiology Edited by Valery L Feigin and Derrick L B...

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In Context

Book Neuroepidemiology not only for neuroepidemiologists

Handbook of Clinical Neuroepidemiology Edited by Valery L Feigin and Derrick L Bennet. Nova Publishers, 2007. Pp 690. US$79. ISBN 978-1600215117

The Handbook of Clinical Neuroepidemiology is a multi-author book offering an exhaustive survey of the epidemiology of neurological disorders. The first chapter provides an extensive and clear overview of fundamental concepts of statistics and epidemiology, and this key part of the book gives readers the essentials on how to interpret and do epidemiological research. The chapter includes a CD that shows how to download a statistical package R (a language and environment useful for data handling, statistical analysis, and preparation of graphics). By using part of data from the Fletcher Challenge Heart and Health Study, the CD provides numerous examples to drive the reader along the intricate paths of statistical techniques. The rest of the book consists of 17 chapters devoted to neurological disorders. These chapters give crucial up-to-date reviews of epidemiology, not only for major neurological diseases but also for disorders for which epidemiological literature is scanty (low back pain, toxic and metabolic disorders, neuromuscular disorders, and neuropsychiatric disorders). Neurological disorders are discussed from descriptive (prevalence, incidence, and mortality) and analytical (risk factors and comorbidities) epidemiological points of view, and the chapters on stroke, traumatic brain injury, neuromuscular disorders, CNS tumours, and

Huntington’s disease include paragraphs dedicated to clinical management or treatment. Migraine is deeply analysed, with special emphasis on its individual and social effects. Other neurological disorders are outlined, focusing on diagnostic criteria and classification (peripheral neuropathies) or nosographic aspects (dementia). The chapter on neurological aspects of ageing is unusual for a neuroepidemiology text because it looks at structural, biochemical, and molecular changes in the brain. Although unusual, this section gives interesting information on the relation between biological changes and cognition and on the interpretation of epidemiological associations. The last chapter reviews measurement scales. Interestingly, outcome measures for clinical trials in neurology are addressed with an original approach—the effect of illness on the patient’s daily life. In this way, the change in quality of life caused by treatment can be recorded. In my opinion, this book would be helpful for specialists in neuroepidemiology, but more so for clinicians who work in neurology and for general health professionals who refer to epidemiology and to evidence-based medicine.

Giovanni Savettieri [email protected]

Illustrated neurology

A Portrait of the Brain Adam Zeman. Yale University Press, 2008. Pp 256. US$27·50. ISBN 978-0-300-11416-4

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Every now and again, one encounters an author at perfect ease with their subject matter—think of Orwell on poverty, Hazlitt on boxing, or Darwin on his travels. Their writing seems effortless (although it seldom is), with pellucid prose elegantly evoking all that they seek to explain. On these occasions, it is apt to talk of masterpieces. A Portrait of the Brain is such a book. In ten short chapters, neurologist Adam Zeman traces the structure and activities of the brain from the micro (atoms in chapter one) to the macro (the soul in chapter ten). The science is explained from scratch, but there is plenty to keep specialists interested. For example, a case study is woven into each chapter—a pertinent tale of medical misfortune that complements the overarching theme. Zeman cuts back and forth between concise expositions of the neuroscience and updates on the patient; eventually, after some dogged medical detective work, the patient’s condition is revealed (fans of US television’s House will enjoy this book). More than the brain is portrayed here: the nature of medicine is also uncovered, with its intellectual cut and thrust, the thrill of chasing down a diagnosis, and man’s ultimate helplessness in the face of an implacable fate.

Portrait explores the history of ailments such as narcolepsy— the author unearths a 19th century account of the disorder— before bringing us up to date with current thinking—in this case, the discovery that the neurotransmitter hypocretin is key to maintaining the barriers between states of consciousness. Zeman explores the knotty subject of memory, and offers the latest theories on déjà vu. There are adept descriptions of the “networks of networks of neurons” that characterise the tissues of the brain, but the author’s real coup is the anchoring of his subject in the ebb and flow of human activity. Zeman confidently fleshes out and illustrates his work with quotes and stories from the reaches of literature. Shakespeare, Hippocrates, and Freud put in appearances, but so does singer/songwriter Joni Mitchell. The excerpts are always relevant, and often unusual. This book is, in short, a remarkable achievement. Hand a copy of it to a student pondering their specialty, or a teenager deciding on which exams to take, and it might well tip the balance: neurology has found a fine advocate.

Talha Burki [email protected]

http://neurology.thelancet.com Vol 7 May 2008