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Doody's Review ServiceReviewer: Elizabeth A. Shuster, M.D.(Mayo Clinic Florida)
Description: This concise but comprehensive book details practical approaches for the evaluation and care of patients with multiple sclerosis.
Purpose: The authors' objective was to provide an accessible book of core information for clinicians treating these patients.
Audience: Although clinical neurologists are the primary audience, this book would be most valuable to general physicians who treat MS patients in their clinics, nurse practitioners in neurology clinics, and residents rotating through MS clinics or managing MS patients in their continuity clinic. Neurologists who regularly treat MS patients are already familiar with most of the content, but will find it useful when teaching medical students, residents, and others on their team. The contributing authors have broad experience in treating patients with MS and are respected authorities in this field.
Features: The book is manageably sized and organized into seven parts and 38 chapters, and includes several unique features. Each chapter starts with key points for clinicians and ends with key points to share with patients. Important points also are highlighted throughout the book, which makes it easy to find the information again when needed. Part I includes a superb chapter on the pathophysiology of MS, written by Drs. Mahad and Ransohoff, that stresses the widespread tissue damage that occurs in MS in both the gray as well as the white matter of the brain and spinal cord. Part IV on rehabilitation and symptom management comprehensively covers the wide range of issues that come up in MS clinics. Chapter 21 on seizures, sleep, and transient symptoms and chapter 22 on ocular symptoms are particularly informational. Unfortunately, the reproduction of the MRI imaging is disappointing, but the authors did an admirable job of pointing out the specific details of MS lesions. I would have liked more in-depth discussions on some issues. For example, there is little discussion of the off label use of cyclophosphamide for aggressive or progressing MS. And while surgical procedures for bladder incontinence are mentioned, when the authors use them and how they chose a particular procedure is not detailed.
Assessment: This concise, well-written book is surprisingly comprehensive for its size. It includes some unique features that make it easy to access what is in each chapter. It will be valuable as a reference, particularly for general neurologists, internists, family medicine physicians, and neurology residents and nurses who see and treat MS patients.