Thiamine Deficiency and Associated Clinical Disorders. David W. McCandless (author). Humana Press 2009, 192 pages, 44 illustrations, $159.00.
This short 192 page book Thiamine Deficiency and Associated Clinical Disorders, which is part of the ongoing Contemporary Clinical Neuroscience series, is authored by David McCandless, Ph.D. who is known for his work in metabolic encephalopathy. For those who wish to have a deeper understanding of a number of metabolic derangements which result in neurological dysfunction, this book would be of interest. For the neuroradiologist there is an opportunity to view gross pathology and histopathology but unfortunately with imaging in only a very limited number of cases. Clearly imaging was not a focus of this book and in this respect the author missed a major opportunity. To spend 17 pages on Wernicke’s Disease and not show any images the disease is a defect in this publication. Similarly there are no images of central pontine myelinolysis, alcoholic cerebellar degeneration, Marchiafava-Bignami, or in a host of serious disease where thiamine deficiency may play a role in the patient’s clinical status.
The initial chapters go through some of the chemical considerations in thiamine deficiency and contain the historical underpinning of these disorders. In fact each chapter sets the stage for the disease by tracing developments which have resulted in the understanding of the disease. The path specimens are worth viewing but they suffer from a lack of labeling (for example the description of “brownish lesions” in the mid brain in Leigh’s Disease, which I don’t see) and inaccurate legends (for example description of “symmetric cavitation” of the lower medulla in Leigh’s Disease where the abnormalities are grossly asymmetrical). In the books favor however is the thoroughness of the discussions of each disease — there are insights are easily transposable to imaging.
A nice ending to the book is Appendix C where the Nobel Prize in Physiology or Medicine Acceptance Speech by Christian Eijkman is reproduced. He was awarded this 1929 for his observations which lead to the discovery of thiamine. It is a fitting ending to this book.
