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The epidemiology of neurological disorders.
  1. JESŨS DE PEDRO CUESTA

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    The epidemiology of neurological disorders. C N Martin, R A C Hughes, eds. (Pp 248; price not stated). London: BMJ Books, 1998. ISBN 0-7279-1149-X

    Neuroepidemiology is an aetiological heterogeneous application field of epidemiology, for instance, compared with cancer or vascular epidemiology, kept compact by the weight of the neurological diagnosis and the expanding size of the population segment affected with neurological disorders. The book ranks fifth in the history of neuroepidemiological handbooks in English1-4and compared with them presents some advantageous and innovative characteristics.

    The updated reviews focus on the most prevalent disorders, such as epilepsy, dementia, head injury, parkinsonisms, peripheral neuropathies and stroke, as well as on less frequent ones (multiple sclerosis and motor neurone disease), but also on aspects not dealt with in previous volumes: schizophrenia and neurological disability. Readers expecting systematic views used in previous manuals including the descriptive, analytical and clinical perspectives of each group of disorders2 will be disappointed. As the editors point out, the book, published as separate chapters in theBMJ does not pretend to be a systematic coverage of the field of neurological pathology. In addition, authors choose, fortunately in my opinion, different approaches with particular interest in aetiology in the well structured chapters on parkinsonisms and dementia, classification in epilepsy, public health in head injury, genetics in multiple sclerosis and basic behavioural concepts in neurological disability, where the book reaches maximum interest. Pioneering the field of disability, in a chapter by D Wade, the manual incorporates a dimension particularly relevant in society, because of the predominance of neurological impairment among the disabled population.

    Methodological aspects, taken into specific consideration in previous manuals remain out of the scope of this book, as well as—surprisingly—highly prevalent, severe or recently debated disorders such as headache, spinal cord injury and CNS infections including Creutzfeldt-Jakob disease. As the references finish at 1996 the book, will be soon outdated, which is a problem particularly relevant in 2000 because of the remarkable recent research results in several aetiological fields (infections and arteriosclerosis, diet and parkinsonisms, cerebrovascular risk factors and dementia, and prions and spongiform encephalopathies).

    An overwhelming majority of clinicians among the author list characterise handbooks in neuroepidemiology. This book is not an exception. While advantages in writing for the majority of readers, clinicians and caring personnel, can be obtained from such choice, others may enjoy the subtle thinking of specific authors such as Ben-Shlomo and Van Duijn in the fields of parkinsonisms and dementia, able to convey clear balanced messages, by overcoming the bipolar threats of the restrictive view versus the uninformative multiple accumulation of results through authoritative criticism and careful reports selection.

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