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Myopathies in clinical practice
  1. R J M Lane

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    Edited by Phillip R J Barnes and David Hilton-Jones. Published by Martin Dunitz, London, 2003, £49.95 (hardcover), pp 161. ISBN 1-899066-71-3

    Text books come in two forms; some attempt to tell you all there is to know while others try and tell you what you need to know. The editors’ introduction to this book suggests that it falls into the latter category but in fact it “punches above its weight” with regard to the depth of coverage in a number of the chapters and includes observations, reminders, and pointers that all myologists, let alone general neurologists, will find extremely valuable.

    Beyond the superficial level, neuromuscular disorders are complicated mainly because we now know so much about their underlying molecular biology. This book goes as far as reasonably possible in making these complexities understandable. It is divided into two sections. The first deals with basic principles, including clinical assessment and the investigation of muscle disease. The writing style is direct and almost conversational—in the style of a tutorial, which many will find attractive. The section on investigation of muscle disease is particularly clear and comprehensive with a helpful exposition on the basics of electromyography in muscle disease and neuromuscular transmission disorders. This section concludes with a chapter on the principals of therapy of neuromuscular disease—a topic which is usually tucked away in the back of a more typical text book—perhaps reflecting the Editors very positive attitude to this aspect of this speciality. To quote them, to say that there is “nothing that I can do for you” is indeed a sad reflection on the lack of a holistical or rehabilitative approach from the clinicians involved.

    The second section deals in turn with the muscular dystrophies, inflammatory myopathies, muscle channelopathies, metabolic myopathies, and the toxic and endocrine myopathies, and concludes with chapters on congenital myopaties and miscellaneaous muscle disorders. The final chapter on neuromuscular junction disorders is included for the sake of completeness. Each of these chapters is to a similar high standard, although I would comment that there is no obvious logic in the way that these are ordered in the book. There is also a comprehensive index that proves efficient on several occasions.

    This volume is commendably short and the text is arranged in a double column format. The production is lavish, profusely illustrated in colour with many diagrams and text boxes, which are beautifully clear. For general neurologists, I think this book will have few serious rivals as a convenient, modern, and comprehensive source of information on the most important aspects of muscle disease, and I can recommend it most highly.

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