Practical Neurology

Practical Neurology. Ed Charles Warlow. Bimonthly, Blackwell Science Ltd . Annual subscription £68 to £170. Rating: ★★★★

Here is a challenge. Clinical neurology is difficult, neurologists clever bores, and neurological journals unreadable. How many want to debate this? An editorial in this issue linked to a paper in the Journal of Neurology, Neurosurgery & Psychiatry (JNNP) and common knowledge among students and doctors are evidence that neurology is perceived as difficult by most who grapple with it—especially part time. According to their peers, neurologists are diagnosticians who astonish others with the superiority of their diagnostic skills and a virtually empty medicine bag—an opinion perhaps self inflicted by neurologists. And journals? Try reading Brain. The journal has undergone a facelift but the papers remain unintelligible, except perhaps to small narrowly focused groups.

That a need exists to make neurological journals attractive and reader friendly is borne out by three recent publications—Practical Neurology, Lancet Neurology, and Neurology in Practice (an educational supplement to JNNP). All three publish review articles aimed at providing crunchy and easy to understand clinical neurology.

Among them, Practical Neurology is perhaps the one most likely to be picked up and read because it is readable, colourful, and contains a broad mix of articles and presentation styles. It uses pullout quotes, plenty of dramatic pictures, figures with clear legends among other journalistic tricks, and delivers comprehensible messages. An article on the neurology of sleep is titled “a wakeup call for neurologists.” Another on trauma and multiple sclerosis has a full page picture of a smashed up car. The journal's editor, Charles Warlow, says, “Our job in Practical Neurology is to be sexy and appealing.”

One of the risks involved, however, is that the journal may be dismissed by village elders as being trite and banal. These critics need to get used to the idea that attractively presented information can be scientifically sound and is likely to be more widely read.

With an ever increasing burden of neurological illness there is a corresponding ever increasing need for people who can deal with common neurological problems. They are more likely to learn from Practical Neurology than from Brain.

A shortage of neurologists exists in most countries including the United Kingdom, which has about 415 consultant neurologists of whom only 45 are women. Has the time come for neurologists to increase their workloads in hospitals and the community looking after people with common neurological problems during the night as during the day, and spend less time and money on esoteric syndromes—a luxury most countries, including Britain, can ill afford?

Other doctors will also need to acquire confidence and competence in neurology if we are to tackle the escalating global burden of neurological disease. The image of neurology needs to change for this practical reason and neurological journals with jeans and T-shirts are more welcome than those with genes and T-cells. (See also editorial on p 1469.)