Field Guide to the Neurologic Examination

Field Guide to the Neurologic Examination

by Steven L. Lewis, 207 pp., Lippincott Williams & Wilkins, 2004

Although many general neurology textbooks devote a chapter to the neurologic examination, few actually explain precisely how to do it. Nor do medical students or residents relish lugging said textbooks about while attempting to learn this vital skill set in bits and pieces from busy clinicians. In providing a clear, readable, and portable grounding in the art and skill of performing a neurologic examination, this book from Dr. Steven L. Lewis fills an educational void.

Field Guide to the Neurologic Examination is a 207-page soft-cover pocket-sized reference, part of the Field Guide series published by Lippincott Williams & Wilkins. The text is divided into three sections. The first briefly reviews the role of the examination and basic premises on neurologic disease mechanisms. The second section, and the heart of this text, describes the comprehensive examination in detail. It is well organized, with each chapter stating the purpose, timing, and detailed instructions on each aspect of the examination. Each chapter also provides information about the expected normal findings, describes abnormal findings, and briefly comments on how to apply those findings to localization and mechanism of injury. The final section discusses how to tailor the examination to each patient during common clinical scenarios, including coma, stroke, headache, and spinal cord injury. The tables, photographs, and diagrams scattered throughout the book are laid out well and easy to read, especially the diagrams demonstrating the motor examination. One small negative is the absence of the Mini-Mental Status Examination; although it is mentioned multiple times, it is not presented formally. It might have been helpful to list it in a table or an appendix for readers unfamiliar with this test.

No book will fully replace the education gained by watching a skilled clinician perform an examination in person nor replace the skills and confidence acquired only by repetition and experience. However, having this book in your pocket is like having that skilled clinician whispering suggestions in your ear. This book is highly recommended for medical students and house staff during their neurology rotations. Neurology residents will eventually outgrow this book, but it will still serve them well early on as a solid grounding in practical examination skills and later as a general reference for less commonly performed aspects of the examination.