Alpert JN. The Neurologic Diagnosis: A Practical Bedside Approach. Springer 2012, 297 pages, 46 illustrations, $49.95.
The Neurologic Diagnosis: A Practical Bedside Approach is a well-written and easy to understand introduction to the neurologic examination and common clinical cases. It is a 297-page softcover edition written by Dr. Jack N. Alpert, who has had a long career in both academic and private practice. He is an enthusiastic teacher, and this comes across in his new textbook. Information is presented in a logical format, with related clinical correlates that help cement knowledge in the reader’s memory.
The book is organized into twelve chapters that cover all neurologic subsets: brain, spinal cord, nerve root, plexus, peripheral nerve, neuromuscular junction, and muscle. The full neurologic exam and common diagnoses are also given their own sections. Emphasis is placed on the need to take a good history, as this is often the most important part of the patient encounter. Illustrations are provided when needed to further clarify anatomy or exam findings. Each image is good quality and has descriptive captions.
Compared to other neurologic texts, this book is written on a more introductory level, but is not short on practical, everyday information that will come in handy when evaluating neurologic patients.
Stroke and neurovascular anatomy are given their own chapter, which will be particularly useful to the neuroradiology audience. This chapter is 23 pages long and covers ischemic, hemorrhagic, and venous infarcts, as well as subarachnoid hemorrhage. There is a good list of the classic lacunar syndromes, each of which has well-established radiologic correlates. An introduction to MR and conventional angiography is provided with a few illustrations that outline the anatomy of the extracranial and intracranial carotid circulation as well as arteries of the posterior circulation. It would be helpful if there were a picture of the venous anatomy, as venous infarcts are a small but still clinically relevant source of parenchymal hemorrhage.
The “Diagnostic Dilemmas” section is a great collection of the less common neurologic diseases and their variable manifestations. Diagnoses such as neuromyelitis optica, frontotemporal dementia, tuberculous abscesses, and neurosarcoidosis are all explained in an easy to understand fashion that encourages curiosity and further learning.
“Common Symptoms in the Neurology Clinic” covers the most frequently seen problems in a routine clinic: headache, syncope, seizure, vertigo, and other transient neurological symptoms. While these may sound simple to manage at first, there is a great deal more detail required to come to an accurate diagnosis. Dr. Alpert manages to distill his experience into useful clinical vignettes that walk the reader through his thought process.
This book would be most appropriate for a senior medical student or junior neurology resident, as it presents detailed information in an easy-to-read format. Senior residents would find the chapters on “Common Symptoms in the Neurology Clinic” and “Diagnostic Dilemmas” useful, as the majority of residency is spent with inpatient experience.
