Neurological Differential Diagnosis (2nd Edition

Palo, John

Doctors of chiropractic are constantly on the lookout for a good book on the clinical aspects of the human nervous system. This one thoroughly covers the field. In our everyday practices, we are always asking ourselves, “Is it a case of this? Or is it that? What further test can I do that will tell me what my patient has?” For questions like these, this is a good text to keep within reach.

The reader is furnished with a plethora of excellent anatomical and physiological illustrations, explanations, tests, and case reports to back diagnostic conclusions.

In this book’s “smorgasbord” of fascinating subjects, nerve root and peripheral nerve problems are thoroughly discussed. As the writer states, “The clinical problem can usually be reduced to a simple consideration: Whether the pain or weakness lies in the territory supplied by a single nerve root or a single peripheral nerve or one of its branches.” He then goes on to explore these possibilities at the spinal column and upper and lower extremities.

This text offers us a chance to compare what we already know with the growing information presented to us through the everimproving new diagnostic modalities, such as CT, MRI, EMGNCVC, SSEP, etc. At the same time, the author stresses the importance of taking a good history and making a thorough office examination. He states, “However dramatic the advances in imaging and the use of databanks, it is unlikely that neurological skills will become extinct in the immediate future.” His office test procedures are well illustrated. They form a good part of his 225 illustrations. Additionally, these illustrations are accompanied by 88 x-ray, CT, and MRI views.

One interesting observation in his clinical examination is that “writer’s cramp” may actually be a prelude to Parkinsonism or other dystonic syndromes.

One of my favorite chapters is the one on headaches. Surely, this is an area where chiropractic services should come to the fore. The author presents excellent material on headache differential diagnosis.

This is a full-range neurological work. It stresses the more common neurological diseases, rather than those rarely seen. The text concentrates on what is neurologically wrong with a patient, but does not attempt to advise us on how to correct the problem.

New to the second edition are coverage of modern neuro-imaging options, case studies, and tips on diagnostic clues and pitfalls.

Author Dr. John Patten is a consulting neurologist. The book is published by Springer-Verlag. The price is $69. For more information, write the publisher at 175 5th Ave., New York, NY 10010-7858, call 212/460-1602, or visit

Copyright American Chiropractic Association Oct 1998

Provided by ProQuest Information and Learning Company. All rights Reserved

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