Philadelphia: Saunders; 2005. 4th ed.
Hardcover, 1984 p., 700 ill.
Fr. 642.30, ISBN 0-7216-9491-8
As a neurologist specialised in disorders of the peripheral nerves I can only welcome the long awaited 4th edition of the textbook “Peripheral Neuropathy”, edited by Peter J. Dyck and P. K. Thomas. This textbook is the definitive reference since it can be hardly compared to any other textbook in this field, because it is so extensive (2 volumes, more than 2700 pages, rich illustrations), but also because of the quality of the experts that have authored or co-authored the different chapters.
To take into account the exciting advances in neurobiology, molecular genetics, immunology and pathology, most chapters have been rewritten to produce the most update reviews.
I have found very interesting information in Volume I (but this is quite a personal view) in reading the chapters on neurobiology of the peripheral nervous system, where a lot of new information is found on myelination, Schwann’s cell-axon interaction, guidance of axons. The neuroimmunology of the peripheral nerve system is extensively covered and the principles of immunotherapy are well described. The chapters of pathologic alterations of nerves and diseases of the neuromuscular junction are particularly informative. Because of the increasing interest in skin biopsy, the chapter on pathology and the quantitation of cutaneous innervation is very timely.
Volume II covers clinical aspects of diseases affecting peripheral nerves. This includes chapters on disorders of cranial nerves, spinal roots, plexus and compressive neuropathies. Inherited neuropathies are discussed in depth and the different chapters have been rewritten extensively to include the everexpanding molecular genetic aspects. In the section “Neuropathy associated with systemic disease” one of the editors (Peter J. Dyck) does emphasise the need to recognise that diabetic neuropathy is not a single disorder by naming the chapter “diabetic neuropathies”. I agree that diabetes may affect the peripheral nervous system in many different ways, I believe though that naming the chapter in the singular form would have been preferable. Interestingly, the plural term “Guillain-Barré syndromes” is also used, the rationale being that we are dealing with a group of heterogeneous but related syndromes. In this respect this new edition reflects the everincreasing complexity of disorders of the peripheral nervous system. One danger of this tendency to split disorders in different subgroups is that the non-specialist is overwhelmed by information. Fortunately, chapters like “Clinical patterns of peripheral neuropathy” or “Differential diagnosis of polyneuropathy” are a useful introduction for a non-specialist.
The interested clinician will find relevant and pertinent information on most clinical aspects of peripheral neuropathies, some chapters though are more informative than others, something that is inevitable in a book that has over 150 contributors.
This textbook should have a place in the library of every neurology department and will be an invaluable reference for all neurologists working in the field of neuromuscular disorders.
A. J. Steck, Basel
