This is an interesting, well written, and useful book—but will not sell many copies. Regrettably it seems pitched at various different audiences and thus I suspect it will not greatly appeal to any particular group. Nevertheless I would thoroughly recommend this book. It contains some excellent descriptions of complex subjects and should be of considerable interest to all practitioners working within the field of multiple sclerosis.

The first part provides an overview of genetics. The first chapter is entitled “What the specialist in multiple sclerosis needs to know about genetics”. It is an excellent overview and easily understandable by the non-specialist. The second part of the book covers the field of immunology. Some of the chapters in this section are rather short and of somewhat patchy quality but nevertheless still provide the non-specialist with a good summary of our present state of knowledge. The chapter, for example, by Neil Scolding on oligodendrocyte injury and the role of complement provides a good update on the subject. The next chapter on cytokines is a little less clear to the non-specialist but nevertheless is useful. The following chapters in this section then become rather too specific to be of use to the non-specialist and probably too superficial to provide any new information to the specialist in the field. The third section covers MRI and once again the same pattern predominates: good updates in the subject but I am uncertain as to whether they are directed to the specialist or non-specialist. The chapter on diffusion MRI is an exception and is beautifully written. The fourth section discusses therapy. John Noseworthy provides his usual excellent contribution on emerging therapeutic options in multiple sclerosis but the chapters on gene therapy and the rationale for antiviral therapies are of somewhat less interest to the clinician.

In the final part(5) the book broadens out even further and discusses various aspects of the organisation of multiple sclerosis care. Personally I found this section of considerable interest but I suspect that those at the more scientific end of the multiple sclerosis spectrum will not find this section very enthralling. However, more scientific colleagues should certainly read the two excellent chapters by Alan Thompson and Jeremy Hobart on advances in multiple sclerosis rehabilitation and an update on outcome measurements.

Overall this book tries to be everything to everybody and thus probably fails in the market place. However, it would be a pity if some of the excellent chapters were lost to a wider audience—so buy it anyway.