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Book Reviews
April 2008

Harrison’s Neurology in Clinical Medicine

Arch Neurol. 2008;65(4):554. doi:10.1001/archneur.65.4.554

Harrison's Principles of Internal Medicineis a household name for medical students, residents, and physicians throughout the world. It has been translated into many languages and is now in its 16th edition. Since its first edition published in 1950, it has contained a section on neurology. Eminent neurologists served as section editors: Houston Merritt, MD, Raymond Adams, MD, and Joseph Martin, MD. Stephen Hauser, MD, currently is the spiritus rector. The publisher and editor decided to publish Harrison's Neurology in Clinical Medicineas a stand-alone volume with the aim “to provide expanded coverage of clinically important topics geared to the needs of the practicing internist, while retaining the focus on pathophysiology and therapy that has always been characteristic of Harrison’s.” The book is organized in 7 sections, each containing between 1 and 32 chapters, with a review and self-assessment appendix. Section 1 is an introduction to neurology that crisply summarizes principles of the pathogenesis of neurological diseases, the approach to the patient with neurological disorders, and neuroimaging. Section 2 provides a symptom-oriented overview of the clinical manifestations of neurological diseases. Section 3 deals with all major categories of diseases affecting the central nervous system, while section 4 covers diseases of the peripheral nerves and muscle. Section 5 reviews chronic fatigue syndrome, section 6 presents an overview on psychiatric disorders relevant to the internist and neurologist, and section 7 addresses alcoholism and drug dependence. The text is enhanced by many excellent tables; boxes outlining the diagnostic approach and reviewing current treatments; excellent flow diagrams encapsulating the diagnostic approach; numerous excellent illustrations using state-of-the-art graphics, often almost artistic in nature; and radiologic images. Each chapter contains recommendations for further readings. Much in line with the tradition of Harrison's Principles, the authors successfully emphasize the etiology and pathogenic mechanisms of neurological diseases and lay out the fundamentals of their treatment. While it is difficult to single out any chapter, those on dizziness, syncope, and vertigo; cerebral vascular diseases; Alzheimer disease and other dementias; Parkinson disease and other movement disorders; ataxias; paraneoplastic syndromes; multiple sclerosis; approach to the patient with peripheral neuropathy; and polymyositis, dermatomyositis, and inclusion body myositis impressed me most as exemplary didactic accounts. I have not detected significant flaws. I do not think that the target audience for this book is only practicing internists; it is equally suited to serve as an excellent reference text for neurologists whether in residency, subspecialty training, or practice.

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