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Immunological and Inflammatory Disorders Of the Central Nervous System
  1. JON SUSSMAN

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    Immunological and Inflammatory Disorders Of the Central Nervous System. Edited by neil scolding. (Pp264, £45.00). Published by Butterworth Heinemann, Oxford, 1999. ISBN 0-7506-2357-8.

    That neuroimmunology has come of age is demonstrated by the profusion of volumes published on the subject in recent years. This volume focuses on the central nervous system, and aims to satisfy the curiosity of both the clinician faced with a diagnostic conundrum and the experimental immunologist inquiring into the clinical relevance of his findings. At first sight it seems improbable that both of these goals might be achieved in one volume; this book however, succeeds admirably in what it sets out to do, as much as a result of its literary style as its content.

    The intrusive authorial voice fell into disfavour in literary circles around the turn of the century because it was thought that calling attention to the act of narrating might detract from realistic illusion, so reducing the emotional intensity of what was being represented. It is a device much favoured by postmodern writers, who expose the nuts and bolts of their fictional constructs. The intrusive medical author never dropped out of fashion, although in these days of evidence based prejudice, authorial omniscience might be considered suspect. The authors of this volume are intrusive in a guiding conversational manner that makes this book by far the most readable of the neuroimmunological texts.

    The book opens with a highly accessible chapter on immune responses in the nervous system. There follows a chapter that integrates the neurobiology of multiple sclerosis with contemporary issues of aetiology, cell injury, and repair. Next, a chapter on inflammatory demyelinating diseases examines syndromes of isolated demyelination, acute disseminated encephalomyelitis and allied conditions, and some of the syndromes of demyelination that are now accepted as part of the range of multiple sclerosis. The chapters on demyelinating disease are drawn to a close by a discussion of existing and experimental therapies for multiple sclerosis.

    The book continues with chapters on paraneoplastic disorders of the CNS, stiff man syndrome, neurological complications of connective tissue disorders, organ specific autoimmunity, sarcoidosis, and cerebral vasculitis.

    Each chapter is an appropriate length and well referenced; the wood is always clearly visible between the trees. This book is sufficiently readable and small to be recommended as holiday reading. Its only drawback is that in making erudition so readily available, one risks being outshined yet again by one's registrar.

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