Adult Neurology

This book is part of Mosby’s Neurology/Psychiatry Access Series, the essential aims of which are to provide specialist information to primary care physicians and to provide a concise but clear guide to the discipline at hand.

The book is laid out in three sections. The first concerns the adult neurological examination, the second reviews common problems in adult neurology, and the third is a review of some neurological diseases or disorders. It is clear from the table of contents that psychiatry has very little play in this text.

The individual chapters are accompanied by clear tables that serve to aid diagnosis, and they also contain “pearls and perils” boxes. There are halting comments in the text when a box is introduced that says “consider consultation when….”

Reviewing this text with psychiatrists in mind, I found it helpful to note that the layout of the tables is certainly helpful, and they are an aid to understanding the neurological conditions being described. What is singularly lacking in the text (apart from a collection of brain scans and EEG tracings) are good diagrams outlining the underlying relevant neuroanatomy to explain the development of symptoms. Familiarity with the neuroanatomy appears to be taken for granted but is such an essential part of understanding neurological disease that this is an error, particularly in a text meant for an audience of psychiatrists who are not sophisticated in neurological differential diagnosis.

As noted, there is no reference to psychiatry in this book. Epilepsy, which is associated with a high frequency of psychopathology (perhaps up to 50% of patients), is treated solely as a neurological disorder. Even in the discussion of Parkinson’s disease there is no reference to psychosis or its difficult management. The index does not mention schizophrenia, and the only reference to depression is in dementia.

These omissions do not necessarily reflect on this book as a potentially friendly book for psychiatrists to learn neurology, but they are a rather sad reflection on the way some neurologists still view their discipline. In summary, this is a helpful text, but it lacks appropriate neuroanatomical diagrams and sticks very strictly to its subject with little imagination.