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Neurologic Disease in Women.
  1. GILLIAN HALL

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    Neurologic Disease in Women. Edited by Peter Kaplan. (Pp 480 $150). Published by Demos, New York 1998. ISBN 1-888799-153.

    This is the second time that I have been asked to review a book on this topic. The first time I approached the task with some scepticism—were neurological diseases in women really so different from those in men that they warranted their own text book? But I rapidly became a convert to the cause, being reminded that there are issues specific to females that influence both disease, investigation, and treatment (pregnancy, breast feeding, menopause, to name the most obvious) and that not all neurological diseases attack the sexes equally. There are also wider socioeconomic and legal issues that play a part in the complete disease picture which many of us neglect too often but which this book is careful to address (see below). Leaving content aside for a moment, this is a beautifully presented book; clearly headed and with wide use of well constructed tables. It encourages one to read on. It seems up to date and well referenced.

    The contributors (40 in total) are exclusively American, and east coast American at that with only occasional forays westward. The text is divided into three sections. The first, entitledGeneral Issues in Women includes an anatomical chapter considering the sex differences of regional brain structure and function. More novel for this type of text, it contains two thoughtful chapters considering women’s health within the context of their lifestyles and women’s health and its relation with the law. This chapter considers issues such as coercive approaches to preventing foetal harm, those relating to informed consent to medical treatment, and difficult choices with neurological implications. The law and the case examples are exclusively American but the issues are universal. This opening section leaves no doubt that this is a book that has taken female issues extremely seriously.

    The second section looks at neurological diseases as they affect females at different life stages, from birth through menarche, pregnancy, and menopause, to the elderly woman. As well as considering genetic diseases that strike at a particular age, these chapters consider the influence of changing physiology and hormonal balance on neurological disease. The third section is the most conventional. Each chapter considers a neurological disease representing these diseases with emphasis on their effect on women and there is, by necessity, some overlap between this and the previous section. As a non-American, I would feel more comfortable to believe that the high number of female patients with peripheral nerve injuries secondary to physical beatings, knife wounds, or gunshot wounds reflected the country of origin of this book!

    If pushed to criticise, the indexing could be more complete and certain conditions considered in more detail, in particular, paraneoplastic conditions associated with breast and gynaecological malignancies. However, that aside, I think this a rather special book and not only a good addition to any neurological library but a useful purchase for anyone interested in female medical issues.

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