Allen I. Arieff and Robert C. Griggs; eds. 477 pages. Boston: Little, Brown; 1992. $126.50.

The information necessary to deal effectively with neurologic diseases all too often appears forbidding, if not inaccessible, to physicians who are not neurologists. Nonetheless, neurologic disorders do represent a significant portion of disorders encountered by any general physician. Cerebral disorders that are metabolic in origin are frequently encountered in a hospital setting and often reflect systemic disease in which the brain participates as but one of several organ systems. The past two decades have seen remarkable strides in our understanding of the pathogenesis and management of diseases of this type, but these advances have often escaped the attention of the practicing physician.

It is in this context that Arieff and Griggs have produced a timely, multiauthored text that assembles an extraordinary amount of information in a cogent, clear, and closely reasoned manner. Some contributions dwell extensively on the basic sciences, whereas others concentrate on clinical aspects of these diseases. All, however, provide a contemporary approach to clinical diagnosis, laboratory investigations, and techniques of management. It would be difficult to think of another source of such information so accessible and so practical in its implications.

As is inevitable in a collection of this sort, the material is uneven. Some sections, such as those devoted to neurosarcoidosis, the acquired immunodeficiency syndrome, and the paraneoplastic syndromes, are succinct and knowledgeable. More detailed chapters are devoted to electrolyte disorders, renal failure, hypoxia, and disorders of carbohydrate metabolism. Unfortunately, not all chapters are as comprehensive or authoritative as these. One would have anticipated, for example, more fully developed discussions of the neurologic manifestations of endocrine dysfunctions and of toxic disorders. Even in generally thorough presentations, such as the one on hepatic disease, greater attention should have been paid to such poorly understood topics as hepatic myelopathy.

Despite these minor criticisms, however, it would be difficult to find such a timely compilation elsewhere, particularly one written in language familiar and useful to the practicing internist or generalist. This book can be recommended without reservation. It will, one suspects, spend more time off the shelf than on, an indication of its utility and authority.