Bertorini TE. Neuromuscular Disorders: Treatment and Management. Expert CONSULT. ELSEVIER SAUNDERS 2010, 472 pages, $199.00.
Neuromuscular Disorders, Treatment and Management, edited by Dr. Tulio E. Bertorini, is an interesting compendium of diverse and fairly inclusive topics in disorders of nerve and muscle, with a spectrum of generally well written and pertinent chapters referencing specific categories of neuromuscular diseases. The expected emphasis on understanding the implications, diagnosis and treatment of the specific muscle and nerve diseases is well done, as is the impact and management on non-neuromuscular disorders of upon the neuromuscular system.
As a practicing physician in the field of neuromuscular disorders, I have read it with interest and used it as a reference manual in the day-to-day practice of seeing complicated patients within the full spectrum of neuromuscular diseases. It contains a basic introductory chapter which is very well-done, and an unusually large range of topics, well-summarized, making it a good reference manual as well as an aid to diagnosis and treatment contained in a relatively small volume. Its accessibility on the internet may make it especially appealing to the younger of us, making it simple to access without necessitating the book’s presence in the office.
The emphasis on treatment is especially evident in initial chapters confronting diverse topics as the approach to managing specific disorders and potential multi-systemic complications. Discussions on disease-specific management of the eminently treatable immunological disorders, and generic approach to management when no specific treatments are available requiring supportive approaches, are all particularly pertinent and useful. Illustrations and diagrams are useful and of excellent quality, making it easy to understand the various pathophysiological processes. Though generally evidence-based, there are some areas of questionable validity, such as the recommendations for treatment of sporadic inclusion body myositis. This does not detract from the excellence of this and the other chapters within this treatise, such as the well-done chapter on neuromuscular junction disorders.
Neuromuscular imaging is certainly not in its nascent stages, with a variety of studies already indicating its usefulness in this realm. Specific patterns of involvement, such as in inclusion body myositis, and the changes noted in various afflictions of muscle, including the secondary changes of denervation, are increasingly becoming important in characterization of these conditions. Newer and more sophisticated imaging techniques are arriving in a seemingly unending progression, and it is only a matter of time before they make a significant, and perhaps critical, impact in soft tissue imaging. I wait for the day that an imaging study can identify the metabolic defect in primary and secondary muscular disorders, or give a specific diagnosis which obviates the need for invasive studies. Hopefully all of this can be done within, and actually improve upon, the efficient use of resources available for medical use.
I very highly recommend this book for all neurology residents, neuromuscular fellows, and those with an interest in neuromuscular disorders, such as physiatrists and orthopedic surgeons. I shall use my copy as a source of useful information in the clinic and for general review. If I had a choice as a radiologist or nuclear medicine specialist, as to an appropriate but not-too-diluted source of information to assist me in the fields of neuromuscular imaging, I would want it to be very much like this offering: not overwhelming in size, very reasonably up-to-date, and with the promise of being available anywhere electronically.
