How do medical students and neurological trainees learn how to examine the nervous system? Opportunities to observe the faculty of master clinicians at work, the apprenticeship model by which many of us learnt, have perhaps become fewer in this age of planned, briefer, hospital admissions. Hence the need for written supplements to clinical training, such as this text, now in its fourth edition.
This book falls into the middle range of “how to do it” books devoted to neurological examination; less than one‐third the length of De Jong's Neurologic examination but double that of Professor MJG Harrison's Neurological skills (now out of print, sadly). A step‐by‐step approach to examination technique (“operationalisation” is the mot juste, I think) is adopted, with additional brief text on possible findings and their interpretation, clinicoanatomical localisation and some clinicopathological causes. Clinical lore garnered from years of experience is much in evidence, such that even those already trained in the art may learn something new. (I particularly enjoyed the Groucho Marx manoeuvre, p 98.)
Emphasis is always an issue in a short book. Some believe, perhaps depending on personal interest, that the relative space devoted to vision and eye movements (7 chapters) and higher mental function (7 pages) is entirely appropriate or totally unjustified. However, there are omissions: I find no account of tongue fasciculations or testing colour vision. In this era of multimedia, students may find the black and white illustrations a little dry—in the UK, examination videos have been with us ever since Dr Anthony Hopkin's study aid was prepared for the Royal College of Physicians in 1993, and CD‐Roms are not uncommon textbook accompaniments these days. The index is unusually thorough but not perfect (eg no mention of inverted reflexes, p 167).
These caveats aside, I have no hesitation in recommending this book, although, as the dedication makes clear, attending those skilled in the art remains the preferred way of learning how to examine the nervous system.