Victor M, Ropper AH. Adams and Victor’s Principles of Neurology

Seventh Edition. McGraw-Hill 2001.

Reviewed by: David J. Gladstone BSc, MD
Fellow, Division of Neurology, University of Toronto.

The collaboration between Raymond Adams and Maurice Victor dates back to the early 1950s at Massachusetts General Hospital and includes over 100 co-authored papers with seminal descriptions of alcoholic cerebellar degeneration, Wernicke-Korsakoff syndrome, central pontine myelinolysis and normal pressure hydrocephalus. Now in its seventh edition, their Principles of Neurology remains a classic text.

This single-volume work summarizes the core of clinical neurology. The organization follows a logical sequence from "symptom to syndrome to disease." The first half of the book deals with the cardinal manifestations of neurologic disease; the second part is devoted to the major neurologic disorders. The book is strong in its clinical descriptions, classifications and diagnostic approach.

In this era of multi-authored and multi-edited textbooks, the limited authorship of Principles of Neurology is a unique accomplishment that distinguishes this book from many others currently available. It is co-authored with Allan Ropper, Professor of Neurology at Tufts University School of Medicine.

The book has appeal for medical students, trainees and clinicians in general practice, internal medicine, geriatrics, psychiatry and neurosurgery. Many practicing neurologists have a personal copy of this text on their bookshelf but need to consult more exhaustive, multi-volume references for the minutiae. A practical pocket companion book is available separately and may be particularly suitable for students and housestaff.

As so much of neurology involves geriatric medicine, practitioners involved in the care of the elderly will find this book to be a valuable resource. Sections of particular interest to the geriatrician are chapters on The Neurology of Aging, Degenerative Diseases of the Nervous System, Delirium and Other Acute Confusional States, and Disorders of Stance and Gait, among others. General practitioners will find useful sections on seizure disorders, cerebrovascular diseases, tremor and other movement disorders and painful neurologic conditions. Psychiatric illness and neuropsychiatry are given special prominence based on the authors' "belief that these diseases are neurologic in the strict sense." Chapters on pediatric, developmental, metabolic and inherited neurological disorders are also included.

The field of neurology continues to advance at rapid pace and this revised edition is updated with knowledge gained over the past four years, during the culmination of the Decade of the Brain. However, in certain places I found the coverage of neurologic therapeutics to be incomplete or outdated, such as the discussion of Alzheimer disease pharmacotherapy. Readers looking for in-depth discussion of current treatment specifics may need to consult other sources. Neuroimaging and (black-and-white) illustrations are relevant and useful, although the ratio of text to figures is high. Many of the tables are excellent. Additional photographs, imaging scans and colour may enhance future editions.

With the passing of the Canadian-born Maurice Victor on June 21, 2001 at the age of 81 years, this textbook is a legacy of his lifetime of contributions to the practice and teaching of neurology.