Brain, Vol. 123, No. 10, 2180,
October 2000
© 2000 Oxford University Press
Book reviews |
MUSCLE DISEASES.
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The Walton Centre for Neurology and Neurosurgery, Liverpool, UK
Muscle Diseases is the twenty-fourth volume in the Blue Books of Practical Neurology series and follows the usual format of a compact volume that intends to provide an up-to-date and comprehensive review of the field. The subject is covered in 12 chapters written by 24 authors in 432 pages. There has obviously been a massive expansion in this area in the last two decades, mainly in the fields of molecular chemistry and molecular genetics, with less spectacular advances in clinical and therapeutic aspects. There is therefore something of a problem for the authors and editors in achieving a balance between describing all that is known about the biochemical and molecular basis of a group of conditions and which clinical features and investigations are useful in diagnosis. The series preface and title both emphasize that the book is aimed at the practicising clinician encountering muscle problems on a daily basis.
The first two chapters are general and cover clinical assessment (Brooke) and the important area of muscle pain and fatigue (Kissel and Miller); they are excellent and provide some pithy comments on non-organic symptomatology. I also liked the `weekend warrior' syndrome. The next chapter, an overview of the muscular dystrophies (Orrell and Griggs) is useful. However, the following chapter `Muscular dystrophies related to deficiency of sarcolemmal proteins', i.e. mainly Duchenne/Becker dystrophies and the identified genetically determined limb girdle syndromes (sarcoglycanopathies), is disappointing in clinical content. A gap in the book is the relatively large number of presently unclassifiable adult-onset limb girdle syndromes that defy diagnosis.
The chapters on myotonic disorders (Meola and Moxley), muscle ion channelopathies (Rudel, Hanna and Lehmann-Horn) and mitochondrial myopathies (Rahman and Schapira) are excellent reviews. DiMauro and Haller's chapter on metabolic myopathies is very readable and also contains much useful practical information about diagnostic tests. `Disorders of the neuromuscular junction' (Middleton), at 46 pages, is long, wordy and rather weak. In myasthenia gravis, surely SFEMG has largely replaced repetitive stimulation as a neurophysiological test? I do not agree that azathioprine is `usually considered' a second line drug in myasthenia gravis for the prednisolone-unresponsive patient. The management of the anti-AChR antibody negative myasthenia gravis patient is avoided. The congenital myasthenic syndromes are important if rare and a brief comment focussing on when and why this diagnosis should be considered would have been appropriate.
Inflammatory myopathies (Amato and Barohn) provides a good overview and emphasizes therapeutic difficulties, not helped by the glaring lack of randomized controlled trials. Wadia and Katrak's chapter on muscle infections is a pleasure to read and should alert us to these disorders, rare in the UK, particularly with increased foreign travel to remote destinations and immigration from tropical countries. The final chapter covers toxic and endocrine myopathies (Zaidat, Ruff and Kaminski). Drug-induced myopathies are difficult and fall into two main groups: drugs that are commonly myopathic (e.g. corticosteroids or AZT), very widely used drugs (e.g. the statins or cimetidine), which may occasionally be myopathic, and numerous other drugs where there have been isolated case reports or CSM notifications.
The book contains references up to 1998. There are some lapses in the indexing. For example, dysferlin (for which an antibody is now commercially available) is mentioned in three places in the text (and in references) but not in the index.
This book is highly recommended for all clinical neurologists, training or trained, coming into contact with patients with muscle disorders and is also a very useful review for the `myologist'. It is also recommended for those working in the closely allied fields of clinical genetics, neurophysiology and neuropathology who need a clinical overview. It is mostly very well produced, well-referenced and readable. It is also very good value at £60.
Notes
Edited by Anthony H. V. Schapira and Robert C. Griggs. 1999. Oxford: Butterworth-Heinemann. Price £60. Pp. 432. ISBN 0-7506-7085-1.
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