Comprehensive Neurology

Comprehensive Neurology

Edited by Roger N. Rosenberg

New York, Raven Press, 1991.920 pp.

Comprehensive Neurology proposes to review “all aspects of neurologic disease,” providing yet another addition to the ever-growing list of neurology references. Its editor, R.N. Rosenberg, claims substantial experience in neurology editorship with The Treatment of Neurological Diseases (1979), Neurology (1980), and the five-volume Clinical Neurosciences (1983); more recently, he has produced shorter studies, including Neurogenetics: Principles and Practice (1985) and Molecular Biology of Neurological Disease (1988). In contrast to other textbooks like Asbury, Mckhann, and McDonald’s Diseases of the Nervous System, which contain two cumbersome volumes of material, Rosenberg hopes with the present volume to produce a comprehensive neurological reference in a single volume, while providing a “detailed, scholarly account” of neurological diseases, synthesizing the basic and clinical neural sciences for clinicians and interested researchers.

Unfortunately, Rosenberg only partially accomplishes his goal, instead producing a book that conveys a fragmented view of neurology. Compared to other comprehensive textbooks, like Asbury et al.’s Diseases of the Nervous System, or even smaller works much as Rowland’s Merritt’s Textbook of Neurology, Rosenberg’s haphazard contribution simply pales. Comprehensive Neurology attempts to touch upon every aspect of neurological disease with chapters by various specialists, on topics from teratology to psychiatric disorders to coma; but the book fails to tackle an in-depth discussion of neurology. Indeed, most chapters do not consider all aspects of their respective topics, and the accounts tend to be either all-encompassing but superficial or else informative but specialized. For example, such chapters as “Diseases of the Autonomic Nervous System” or “Cerebellar Disorders” provide only brief descriptions of clinical phenomena, while “Headache Syndromes” and “The Comatose Patient” provide informative detail on pathogenesis, clinical presentation, and treatment, albeit limited to their specialized disease. The book treats more general topics rather lightly, though it offers excellent timely information on particular specialized subjects. The result is, by avoiding a thorough coverage of basic neurological concepts and disorders, its utility as a reference diminishes.

Comprehensive Neurology further suffers from a lack of focus or direction in editorship. The table of contents itself reflects a dense conglomeration of chapters without any obvious logical sequence. Many chapters overlap in coverage of several topics, including such conceptual issues as the principles of magnetic resonance imaging and computerized tomography, or such background issues as the neuroanatomy of the vestibular or ocular systems. As the most obvious example, even though Rosenberg generally devotes, at most, one chapter to individual sensory systems, the eighth nerve system alone receives two chapters of coverage, and the majority of their content reiterates information found in other chapters. Moreover, despite Rosenberg’s expressed desire to coordinate basic science with clinical disease and treatment, chapter formats vary tremendously, with some chapters presenting mostly background information, like G. Rosenberg and Wolfson’s chapter on brain fluid and electrolyte disorders, while other chapters present only clinical information, for example, Damasio and Tranel’s chapter on disorders of higher brain function. Some chapters even stray from their title topics: Hecox and Hogan’s chapter, “Diagnostic Principles in Neuro-otology,” for instance, scarcely even addresses diagnostics and instead focuses on neuroanatomy and physiology, while Richter and Corder’s “Neurotoxic Syndromes” chapter concentrates mostly on substance abuse, virtually skipping the role of biological toxins or metabolic toxicities. On the other hand, such chapters as Kase et al.’s on cardiovascular disease, Chad and Munsat’s on muscular disease, and Wray’s on neuro-ophthalmologic disorders clearly and concisely provide thorough, up-to-date information about their respective fields. Laudably, these chapters provide informative, thoughtful presentations. In my view, this volume contains a great diversity of writing quality and content, reflecting an editorship that allows the book’s contributors overmuch free rein to digress. The end product strays too far from the claim “comprehensive neurology.”

In light of other alternative neurology references, a clinician or any interested scientist might therefore find little of interest in Rosenberg’s Comprehensive Neurology, other than some specialized topics such as multiple sclerosis, metabolic encephalopathy, and the aforementioned cardiovascular, muscular, and ophthalmologic diseases. The book’s chapters generally offer unsatisfying whirlwind tours of neurological disorders, never providing a unique or novel presentation of the material. Other contemporary works provide identical information, presented in a more pragmatic, informative, and concise manner, such as Swash and Oxbury’s Clinical Neurology (1991) or, particularly, Asbury et al.’s thoughtfully organized and edited Diseases of the Nervous System (1992). Rosenberg’s present work fails to satisfy the requirements for a comprehensive neurological work in one volume because it rambles through neurological discourses. The editor and his contributors have unfortunately and disappointingly produced a weak overall contribution to the neurological library.