Neurological Therapeutics: Principles and Practice

Book Review Neurological Therapeutics: Principles and Practice, edited by John H. Noseworthy, 2944 pp, with illus, $350, New York, NY, Martin Dunitz (telephone: 800-634-7064), 2003, ISBN 185317-623-0 Type and Scope of Book: A comprehensive review of neurologic therapeutics. Contents, Strengths, and Deficiencies: This exceptional book has already become the standard comprehensive text for neurologic therapeutics. In the interest of full disclosure, it should be stated that I am an editor of Current Therapy in Neurologic Disease. In contrast to Noseworthy’s text, this popular book focuses on an experience-based, expert-based review of neurologic management and therapy, is written in an abbreviated format, and is not extensively referenced. In reviewing Noseworthy’s text, I sampled several chapters with the aim of finding concordant and discordant information. It is not clear to me why the treatment of the same disease is included in different locations in the book rather than being cross-referenced in a more user-friendly style. For the most part, the chapters are authoritative and well written, with excellent use of tabular material. The chapter on trigeminal neuropathy and neuralgia is perhaps a model chapter for this type of book, briefly reviewing epidemiology, etiology, pathophysiology, genetics, and clinical features and focusing the majority of the text on treatment, including a historical overview and presentation of the quality of the evidence for various therapies, combined with the experienced author’s personal recommendations. As a minor criticism, gamma knife therapies are not discussed. I identified some minor deficiencies that will probably be addressed in the next edition. For example, the chapter on giant cell arteritis overlaps with the description of giant cell arteritis in the chapter on vasculitis. Furthermore, there is no mention of the diagnostic value of C-reactive protein measurements, the use of intravenous pulse corticosteroids, or recommendations for corticosteroid-refractory giant cell arteritis. Finally, the diverse ocular manifestations are not described in detail. I found the section on isolated angiitis of the central nervous system too vague, with no mention of biopsy or the sensitivity and specificity of angiography. In contrast, the chapter on optic neuropathy is comprehensive and well illustrated and deals extensively with the anatomy, pathology, and pathophysiology of optic neuropathies, reviewing in detail results of treatment trials such as the Optic Neuritis Treatment

Grading Key ★★★★★ = outstanding; ★★★★ = excellent; ★★★ = good; ★★ = fair; ★ = poor.

© 2005 Mayo Foundation for Medical Education and Research

Trial (ONTT). In contradistinction to chapter 15 on giant cell arteritis, intravenous methylprednisolone is recommended for patients with anterior ischemic optic neuropathy. In the chapter on tinnitus and deafness (a lengthy 19 pages), 10 pages are devoted to anatomy, etiology, clinical presentations, and investigations. The section on hearing aids is well written and interesting but probably of limited appeal to the average neurologist. Almost an entire page is devoted to the selection of the various types of ear molds and factors to be considered in fitting hearing aids, again more than the audience might need. Other chapters, for example chapter 54 on spinal cord vascular syndromes, provide well-written descriptions of spinal cord infarction, but because no definitive treatment exists for this condition, the recommendations are essentially generic. In summary, this is an excellent book that could be improved by trimming chapter lengths, focusing on what the audience really needs, and ensuring consistency among chapters dealing with the same disease. Recommended Readership: Neurologists, neurosurgeons, and internists. Overall Grading: ##### Justin C. McArthur, MBBS, MPH, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Md