Multiple Sclerosis: Clinical and Pathogenetic Basis

Multiple sclerosis is a serious condition to the patient and their family, an awesome task to the clinician who confronts it, and a formidable challenge to the investigator who chooses to research it. With evidence implicating an immunologic basis for lesion pathogenesis and the myelin sheath as the primary target, there has been in recent years, a heavy bias towards a break in self-tolerance and autoimmunity as major mechanisms. This and other immunologic anomalies now figure prominently in several treatment modalities and are presented in a balanced fashion in many of the accompanying chapters.



The editors labored long over the composition of the table of contents and contributors. Accordingly, they decided to meld the works of clinicians from several disciplines with laboratory-based scientists actively researching neuroimaging, electrophysiology, molecular neuropathology, neurobiology, immunopathogenesis and virology. To accomplish this, the book is divided into four sections: clinical parameters, neuropathology and etiopathogenesis, primary treatments, and symptomatic treatment based on advances in psychiatry, medicine and surgery. Cumulatively, these are areas that have helped to accomplish the goal of full longevity and modestly improved quality of life. In an attempt to keep abreast with developments in the field and to counter the possibility of becoming prematurely outdated, each chapter not only provides didactic coverage but also indicates recent trends and makes prediction for the future. Some sections are even more speculative and provide rationale for therapies not yet in vogue. The net result is a fresh, kaleidscopic overview of multiple sclerosis from both the applied and basic standpoints - the balance between broad brush strokes and fine details has been carefully weighed.

C.S. Raine, Albert Einstein College of Medicine, New York. H.F. McFarland, National Institutes of Health, Bethesda, Maryland. W.W. Tourtellotte, Wadsworth Hospital, Los Angeles.