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Multiple sclerosis

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    Multiple sclerosis. By george d perkin and jerry s wolinsky. (Pp 68, £12.00.) Published by Health Press, Oxford, 2000. ISBN 1-899541-28-4

    This book is written as part of the Fast Facts series to serve as guides to clinical practice. It is envisaged by the authors that the book would be of particular value to family physicians but also nurses and paramedical staff involved in the care of patients with multiple sclerosis.

    In the first chapter, dealing with epidemiology, pathology, and pathophysiology, an up to date account is given of the immunological aspects of the condition, which should be of particular value to the reader unfamiliar with inflammatory disease of the nervous system. In the following chapter, on classification, presentation, and early stages, it is particularly helpful to have several case histories which illustrate the various symptoms and presentations listed. Of particular value is a section on questions which patients often ask, with sensible and balanced answers in the chapter on the established condition. The criteria applied to the diagnosis of multiple sclerosis are outlined.

    The book then considers treatment aspects of the disease and begins with treatment of acute attacks and symptomatic measures. Of particular interest is the section on symptomatic measures including a practical account of management of spasticity and bladder, bowel, and sexual problems. In a chapter on treatment with immunomodulators an overall view of the evidence for β-interferon in relapsing disease and glatiramer acetate copolymer 1 is given and brief reference to immunoglobulin. Clearly such a treatment chapter depends on an evolving data base of results from clinical trials. Paramedical staff and support groups and future trends are the subjects of the last two chapters. The practical guide to the role of the physiotherapist, occupational therapist, speech and swallowing therapist, and psychologist should be of use to the interested physician.

    The authors are well respected and experienced clinicians in the field of multiple sclerosis and although the general approach and various views expressed in such a text will necessarily reflect individual or combined opinions, most of the points raised and conclusions drawn would be supported by most neurologists with an interest in multiple sclerosis. The text is not referenced in a formal way although towards the back of the book a list of references is given to selected subject areas and important clinical trials. Overall I think that the book is a useful addition to the multiple sclerosis library and in particular will be of value to family physicians, nurses, and therapists and probably neurologists and physicians in training as a fast reference manual. For the interested and stimulated reader further details will be found in more formal reviews of disease process and its treatment.

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