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Book Review

University of Miami School of Medicine, Miami, Florida

The first question that arises is, why review three books on neurology in a journal on nutrition? Whether accepted by none or by many, the author of these reviews has seen himself, on more than one occasion, in need of managing his nutritionist patients suffering from one or several neurological diseases.

Let’s remember that the nervous system is the "master machine" that holds and moves the human body. It is also true that the physician or health care worker who limits himself or herself to his or her specific field, covering only the boundaries of the field, fails to acquire a thorough and fulfilling knowledge of other medical specialties which make medical culture so gratifying.

The first two books are brief exposés of the neurological science, and physicians and health workers who brief through their contents do nothing more than increase their medical knowledge and culture. By reading or having handy the third more expansive book, they can have at their fingertips consulting material covering an illness which may be seen complicating many diseases.

Neurology in Primary Care. Joseph H. Friedman. Boston: Butterworth-Heinemann, 219 pp, 1999.

This is a small pocketbook-size manual, perfect for any and all health care workers. It covers in 12 sections, and in short and clear form, the most salient matters of neurology. Its beauty and usefulness rests in the succinct but complete manner of reviewing this interesting field. It begins by covering in its first two sections headaches and dizziness. Then it moves to more complicated matters of the nervous system such as radiculopathies, epilepsy, memory loss and disorders of vision. Finally, it enters more sophisticated and complex matters of this field such as transient ischemic attacks, strokes, neuropathies and myopathies. Finally, it winds up with a section curiously titled "Famous Diseases." These include myasthenia gravis, Parkinson’s disease, amyotrophic lateral sclerosis (the illness made famous by the Iron Horse, Lou Gehrig), multiple sclerosis, normal pressure hydrocephalus (an illness exclusive of adulthood and one of difficult management) and, finally, an illness very few of us know the existence of, the Shy-Drager syndrome, a rare form of Parkinson’s disease. If any health care worker would like to have a "bird’s eye view" of this complex field, this is the book to have handy.

This book finishes with two sections of greater interest to the neurologist than to the general health care worker: "The Neurologic Examination and Neurologic Tests."

This small booklet on neurology won’t make an expert on the nervous system, but it will help to increase the reader’s medical culture and basic knowledge of the most common neurologic illnesses.

Neck Complaints. Michael Ronthal. Boston: Butterworth-Heinemann, 140 pp, 2000.

This is another small pocketbook publication. It is one of the books included in The Most Common Complaint Series. This book is composed of simple publications directed to the general group of health care workers. The series in which it is included presents a number of specific pathological conditions, for example, tremors and confusion. Written in brief and simplified form, it covers a large group of neurological cervical clinical entities. According to clinical neurologists, complaints related to the cervical spine are among the most common presenting symptoms seen by them. We should not forget, the present reviewer believes, that the human skeleton is made to be maintained on four extremities and horizontally. Once the human being decided, as proposed, in the opinion of the present reviewer, by Darwin’s theory, to stand up and maintain the spine from neck to coccyx in a vertical position, all the maladies of these skeletal structures began to present themselves. Drug treatment of these pathologies, whose main symptomatology is pain, has evolved from the simple amylobarbitone, through the Librium/Valium phase, to the more complicated and effective non-steroidal antiinflammatory drugs such as Vioxx and Celebrex. Even if the physician in general should pursue the diagnosis through the modem CAT scan/MRI procedures, we should not forget that our main business is relieving pain.

This short textbook begins with a thorough historical introduction, covering from the primitive Edwin Smith papyrus (1862) to the modern methods of diagnosis and treatment (including surgery).

This work, like the previous one, is divided into 12 sections, which include, among others, "Neck Pain and Headache," "Neurologic Symptoms and Signs," "Pathophysiology," "Treatment" (medical/surgical), "Cervical Spondylosis," "Whiplash Injuries" (the phantom of the insurance people), and complex diagnostic procedures such as "Electromyography" and "Nerve Conduction Studies." The last chapter gives, in simplified manner, a "Summary of Treatment Options."

Like the previous one, this pocketbook allows the health care worker to obtain a "bird’s eye view" of neurology and the acquisition of potential management of the simplest of neurological treatments (such as pain relief) until more complex management can be performed by well-trained neurologists.

Peripheral Neuropathy: A Practical Approach to Diagnosis and Management. Didier Cros, ed. Philadelphia: Lippincott Williams and Wilkins, 432 pp, 2001.

This is a thorough neurological text covering the above mentioned disease. This book has several contributors, all experts in different areas of this relatively complex entity. Indirectly, nutritionists and health care workers in general could benefit from certain areas of this publication since peripheral neuropathies are complications of common diseases, some related to nutrition.

Most commonly, peripheral neuropathies are seen as a complication of diabetes mellitus, AIDS, the Guillain-Barré syndrome and several malignant diseases as an invasion by primary tumors or metastases, also as side effects of treatment with drugs or radiotherapy (paraneoplastic neuropathies), and finally this complex illness can be seen in the course of hidden toxicity by heavy metals such as lead, copper and so on. Notwithstanding the numerous illnesses that can present with peripheral neuropathies, even in medical centers specialized in this progressive and painful illness, 25% to 50% of cases go undiagnosed as it refers to its cause. Demyelinization of peripheral nerves is a common occurrence in peripheral neuropathy.

This important book on peripheral neuropathies is divided into five extensive sections covered by the 31 contributing authors. These sections are:

Section I. Assessment of Polyneuropathy.

Section II. Acquired—Demyelinating Polyneuropathies.

Section III. Neuropathies and Systemic Disorders.

Section IV. Recent Advances.

Section V. Polyneuropathies: Diagnosis and Management.

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