Abstract
It is slightly disarming to find a typographical error on the title page, this sixth edition is dated 1993 but the contemporary references, including some in 1997, are reassuring and the latest edition of Mechanisms and Management of Headache is a worthy successor to the first five.
The co-authors, Professor Lance is joined by Professor Goadsby for this new edition, justify the new volume by the considerable advances in research and treatment of headache during the past 5 years. The section on pathophysiology and treatment of migraine has been considerably expanded and the practical guide to the use of triptans in symptomatic treatment of migraine will be helpful to most neurologists.
It is surprising that, although the association of familial hemiplegic migraine with the chromosome 19 missense mutation is described in the chapter on pathophysiology, CADASIL is only mentioned in the section without detail of the molecular genetics. It is suggested that there is an ‘hereditary migraine threshold’ but this concept is not pursued nor are suggestions offered as to its nature.
The strength of this book is as a practical guide, written by acknowledged authorities, for the investigation and treatment of the patient presenting with headache: its weakness is that the authors occasionally write not of their own experience and beliefs but reproduce the, often unsupported, results of others. This is most evident in the section of post-traumatic headache and headache associated with ‘whiplash’ injury. It would have been useful to have a distillation of the authors' views on these syndromes and their opinion of some of the published papers.
Despite these reservations the book is a useful synthesis of current knowledge and will find a niche in the library of physicians treating people with headache.