General physicians have always found neurology difficult and perhaps intimidating. This is a reflection of inadequate training and perhaps perpetuated by the neurologists of a bygone era. Neurology still remains the most clinical of the medical subspecialities—investigative tools such as MRI and DNA analysis will never replace the basic neurological historytaking and examination, which when performed skilfully, is wonderful to watch. This is not some voodoo technique revealed to the chosen few but can be learnt from good role models and practise.
Even today, neurological training remains a clinical apprenticeship with hints and ‘clinical handles’ that are passed down from teacher to pupil and are not in the standard textbooks. In this book we have tried to pepper these in when appropriate. In keeping with the style of the Oxford Handbook series the format is necessarily didactic and hopefully clear for the reader when faced with a patient with neurological symptoms and signs.
Neurology and neurologists have had a reputation for ‘being elephantine in their diagnostic skills but murine in their therapeutic strategies’.
This has changed with numerous treatment options now being available.
Although neither dramatic in their benefit nor curative, options now exist for patients with multiple sclerosis, Alzheimer’s disease, motor neuron disease, Parkinson’s disease, and ischaemic stroke.
Our hope is that this book will go some way to smooth the neurological pathways for juniors in training and perhaps even some senior colleagues!.
1. Neurological history and examination
3. Common clinical presentations
4. Neurological disorders
6. Clinical neurophysiology
Appendix 1: Neurological disability scales
Appendix 2: Clinical pearls
Appendix 3: Neurological eponyms
Appendix 4: Useful websites
Title: Oxford Handbook of Neurology
Author: Hadi Manji, Seán Connolly, Neil Dorward, Neil Kitchen, Amrish Mehta, Adrian Wills