e u r o p e a n j o u r n a l o f p a e d i a t r i c n e u r o l o g y 1 6 ( 2 0 1 2 ) 9 9

Official Journal of the European Paediatric Neurology Society

Book review

The MRCPCH clinical exam made simple. Stanley

Tamuka Zengeya, Tiroumourougane Serane V, Oxford

University Press (Oxford Specialty Training) 2011. Soft cover.

197 pp D DVD. £39.95, ISBN 978-0-19-958793-3.

A hazard of being a reviews editor is that a bookmay arrive

on ones’ desk unsolicited, as this one did. Perhaps the

publishers imagined that the contents would interest readers

insofar as 40% of the pages are more or less on neurological

evaluation (central nervous system, cranial nerves, cere-

bellum, developmental examination, musculoskeletal).

One of the authors is a consultant paediatrician in UK, the

other (having obtained the MRCPCH) is associate professor in

Puducherry (formerly Pondicherry and origin of the fictional

character in Life of Pi, a wonderful story dogged by accusations

of plagiarism by those who perhaps do not concur with Rud-

yard Kipling that “In our trade we be all felons, more or less”

a quote that ends Kyril Bonfiglioli’s even more wonderful All

the tea in China).

Rather than give the volume right away un-read to a young

MRCPCH1 candidate, it seemed fair to look at what aspiring

children’s doctors are being taught in the UK, guessing that

something similar may happen in other lands.

There are quite detailed chapters on the history and on the

various types of examination, coupled with videos of several

aspects. Unfortunately, there does not seem to be emphasis

on what is important in clinical practice. There is nothing on

eliciting the history of a paroxysmal event, a tape measure is

not one of the items of equipment for the neurological

examination, and the neurological examination begins with

“expose the child adequately”. There is no indication of what

1 Member of the Royal College of Paediatrics and Child Health,previously the British Paediatric Association.

information may be obtained by simple observation of

a clothed toddler and little about infant neurology at all.

Although there is a lot of information given there is a dis-

turbing lack of discussion aboutmeaning and significance. For

example, Romberg’s test is described in the section on disor-

ders of the cerebellum as if when “positive” it indicates

a cerebellar disorder!

The videorecordings on the DVD are also sometimes

helpful but of limited scope. Once again, what the examina-

tion result means may be left completely unexplained.

For example, in the only video accompanying the chapter on

examination of the central nervous system, there is

a demonstration on “how to examine the upper limb”. The

specialist finds gross weakness of the left upper limb with

extreme poverty of movement, hypotonia and brisk tendon

reflexes. The boy has some weakness of the left side of the

face. We are not shown what is the situation with the lower

limb(s) and there is no history given or any discussion of what

might be the explanation of this remarkable clinical picture.

Paediatric neurology teaching is too important to leave to

general paediatricians, and I am sorry that I cannot recom-

mend this book at all.

John Stephenson

c/o Fraser of Allander Neurosciences Unit,

Royal Hospital for Sick Children, Glasgow, UK

E-mail address: john@jbpstephenson.com

1090-3798/$ e see front matterdoi:10.1016/j.ejpn.2011.11.002