Neurology: A Clinician’s Approach

Medical students and junior residents are given a list of various “must-read” notes, books, or syllabi at the beginning of their rotations in neurology. Most of these books are either extensive neuroanatomical texts or texts solely concentrating on clinical management. Unfortunately, very few books are available that try to bridge the gap between basic neuroanatomy/neurophysiology and advanced clinical management. Dr Tarulli's Neurology: A Clinician's Approach aims to bridge that gap, and I think that he has succeeded in doing so.

This book is primarily for senior medical students and junior neurology residents. It provides a symptom- or problem-based approach to various neurological conditions. It contains 23 chapters, each dedicated to one unique symptom or group of similar diseases. Each chapter starts with a brief discussion of the salient history of the symptom or group of diseases, followed by a discussion of the neurological examination tools relevant to the chief complaint and a summary of the various differential diagnoses to be considered when faced with a particular chief complaint. Each chapter is supplemented by numerous well-illustrated figures, tables, magnetic resonance or computed tomographic images, and references to other electrodiagnostic studies (including electromyographic and electroencephalographic waveforms). Each chapter also includes a short but important reference list for the keen reader who might want to read further about the various examination techniques or diseases discussed in a particular chapter.

The book is very well written and easy to read, and it also contains important and often overlooked practical teaching points. Instead of having each chapter be exclusively about neuroanatomical material, the author did an excellent job of describing various examination techniques and how they help with localization. This approach, contrary to a typical neurology textbook, makes each chapter clinically meaningful to the reader, especially to a medical student who is being exposed to clinical neurology for the first time. Another highlight of the book is the brief but very useful discussions of various diseases that are relevant to the chief complaints. For example, the chapter on parkinsonism contains key historical points and discusses the various examination techniques used; it also contains discussions of idiopathic Parkinson disease and the various treatments for it and of Parkinson-plus syndromes. The author also included some chapters on pain syndromes, including back pain, various types of headaches, and complex regional pain syndrome.

Although almost all of the chapters are adequately supplemented with tables and figures, some of the chapters are quite short (especially the one on gait disorders), but this is only a very minor criticism. I realize that the book aims to provide a symptom- or problem-based approach and that an in-depth discussion might not be possible in all cases. To make the book even more useful, in future editions, the author and publisher might want to consider adding an appendix of the various examination techniques (in the form of a CD or online teaching tools). For example, after reading the well-written description of the Luria test in the chapter on dementia, a novice might not be able to perform it at bedside, and a figure might have helped in that regard.

Overall, I would strongly recommend this book to any medical student or junior resident starting their training in neurology. I believe that the book is very easy to read and that the various illustrations of key concepts, together with the well-written prose, make it easy for the reader to retain information. I congratulate Dr Tarulli on writing such an excellent book.

Prose ★★★★
Illustrations ★★★
Science ★★★
Usefulness ★★★★