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Those familiar with previous incarnations ofMcAlpine's Multiple Sclerosis will know that authors have changed from one edition to the next and with that the emphasis has changed as well. This third edition is no exception and it is almost entirely a new book. It has six outstanding authors, each bringing formidable authority to bear on their own and their colleagues' contributions. The book is big and aims at a more comprehensive coverage of the subject than previous editions. It is, however, no mere indiscriminate assemblage of the facts, but very much reflects the views, indeed the vision (individual and collective), which the authors have of the pathogenesis and natural history and epidemiology of multiple sclerosis.
Professor Alastair Compston has the lion's share of the writing, and is in his element on epidemiology and genetics and the cellular biology of neuronal and glial cells. He starts the book with an absorbing and scholarly historical piece.
Far from resting on his laurels Professor Bryan Matthews has extensively rewritten and updated his chapters on symptoms and signs and differential diagnosis.
Magisterial is a word Compston is fond of using to describe the achievements of luminaries from the past and it could reasonably be applied to Professor Ian McDonald's professional lifetime of laboratory and clinical research which is reflected in his chapters on pathophysiology and diagnostic methods and investigations.
There are stimulating and provocative chapters on the natural history and on neuropathology. Arguably we all need to try to understand the immunology of multiple sclerosis, particularly in the current era of therapeutic strategies aimed at modifying the course of the disease. Clinicians may think that a chapter on animal models of multiple sclerosis will not be of immediate relevance to their day to day work, and may think that more space could have been apportioned to some aspects of symptomatic treatment and the management and rehabilitation of patients with moderate or severe disability.
This is a very fine book; instructive, edifying, and enjoyable, chiefly because of the writing but also because of the quality of the print and the abundance of excellently reproduced illustrations.