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Doody's Review ServiceReviewer: Katherine Riordan, MD (Mayo Clinic Arizona)
Description: This short introduction to a sampling of neuromuscular disorders both rare and common also provides a brief overview of potential treatments and the multidisciplinary approaches needed to accommodate a neuromuscular patient's unique needs.
Purpose: The authors state the purpose is to provide practical advice to a wide array of healthcare staff, from therapists to physicians, concerning the care of neuromuscular patients. Certainly, this is a commendable objective as the care of these patients requires the involvement of a large multidisciplinary team, many of whom may not be intimately familiar with their needs. The book provides a nice, concise overview of select diseases with high-yield information on the associated genetics and clinical features. It briefly discusses a wide variety of practical issues in the care of these patients, including mobility needs, supporting caregivers, and advanced planning for eventual deterioration. While providing an interesting cursory look into the subspecialty for ancillary staff, it will unlikely be detailed enough for practicing physicians or residents.
Audience: The authors have targeted the book at physicians, therapists, nurses, and all non-neuromuscular healthcare workers. The cursory look at the multidisciplinary nature of the subspecialty could be useful for anyone not familiar with neuromuscular disease. It does not provide enough guidance for any particular team member to use as a manual for patient care.
Features: The book begins with an overview of a sample of both common and rare neuromuscular disorders that nicely outlines key clinical features and genetics. Additional chapters briefly discuss the medical management of these patients in outpatient and hospital settings. Concerns related to the respiratory care, mobility, speech and swallowing, and social issues of this special patient population are all covered. A great deal of the book is devoted to discussing specific mobility-preserving interventions and devices, and high-quality photographs depict these devices nicely. Other very practical issues such as driving, terminal care, and pregnancy are briefly mentioned. The book is quite thorough in at least touching on the various aspects of neuromuscular patient care, including those that are not immediately intuitive for the unfamiliar clinician. Although the book has a very short section on hospital admission that very broadly describes some potential pitfalls, the authors provide no specific information on topics such as how often to monitor respiratory function or when to consider intubation, which are critical issues for physicians. Possible poor reactions to various anesthetics are mentioned, but no specific agents are described. A brief list of specific medications to avoid in particular conditions such as myasthenia gravis would add a great deal of value to this manual.
Assessment: This work gives non-neuromuscular healthcare workers a glimpse into the complexities and challenges involved the care of the neuromuscular patient. It is appropriately targeted at this audience, but does not provide sufficient detail regarding the acute care of these patients in order to serve as a manual. The book covers a great many practical topics, but omits key information critical to the management of hospitalized patients with neuromuscular disease.