McAlpine's Multiple Sclerosis

Since 1955, this landmark masterwork has been revered for its authoritative presentation of the entire state of scientific and clinical knowledge about multiple sclerosis. This new edition summarises the state of knowledge on this common neurological disease to mid-2005. No person who aspires to know about multiple sclerosis can do without this book! The state-of-the-art 4th Edition presents the most recent information on the genetics and epidemiology, clinical neurology, pathogenesis, and management of this common neurological disease. Amply illustrated and referenced and beautifully written, McAlpine's Multiple Sclerosis has been described as "A standard reference for multiple sclerosis researchers, embryonic 'MS-ologists' and hard-pressed clinical neurologists alike" (Brain, review of the last edition). Reviews the earliest clinical and pathological descriptions of multiple sclerosis. Offers a very strong section on pathogenesis. Includes more than 550 high-quality illustrations clarifying important scientific and clinical concepts. Uses a remarkably clear presentation to make complicated data as easy as possible to understand. Presents the most recent information on genetics and epidemiology, with an emphasis on clinical relevance. Covers all of the latest approaches to diagnosis and management. Offers new chapters on treatment of the acute relapse, treatment of symptoms, and disease-modifying treatments. Includes contributions from four new world-renowned authors to reflect more international perspectives. Features a new, more user-friendly page design for enhanced ease of reference.

Table of Contents:
SECTION ONE: THE STORY OF MULTIPLE SCLEROSIS 1. The story of multiple sclerosis The evolving concept of multiple sclerosis Naming and classifying the disease: 1868-1983 Clinical descriptions of multiple sclerosis: 1838-1981 Personal accounts of multiple sclerosis: 1824-1991 The social history of multiple sclerosis: 1945-1998 The pathogenesis and clinical anatomy of multiple sclerosis: 1849-1977 The laboratory science of multiple sclerosis: 1912-1981 Discovery of glia and remyelination: 1858-1988 The aetiology of multiple sclerosis: 1883-1976 Attitudes to the treatment of multiple sclerosis: 1841-1983 SECTION TWO: THE CAUSE AND COURSE OF MULTIPLE SCLEROSIS 2. The distribution of multiple sclerosis The rationale for epidemiological studies in multiple sclerosis Definitions and statistics in epidemiology Strategies for epidemiological studies in multiple sclerosis The geography of multiple sclerosis Epidemics and clusters of multiple sclerosis The environmental factor in multiple sclerosis 3. The genetics of multiple sclerosis: Genetic analysis of multiple sclerosis Methods of genetic analysis Racial susceptibility Sex differences in susceptibility Familial multiple sclerosis Candidate genes in multiple sclerosis Systematic genome screening Lessons from genetic studies of experimental allergic encephalomyelitis Conclusions 4. The natural history of multiple sclerosis Introduction Definitions Onset Course Inter-individual variability Factors affecting the prognosis General considerations Environmental influences Chapter 5: The aetiology of multiple sclerosis: an epitome SECTION THREE: THE CLINICAL FEATURES AND DIAGNOSIS OF MULTIPLE SCLEROSIS 6. The symptoms and signs of multiple sclerosis. Multiple sclerosis as a neurological illness Initial symptoms Symptoms and signs in the course of the disease Individual symptoms and sign Associated diseases Conclusion 7. The diagnosis of multiple sclerosis Diagnostic criteria for multiple sclerosis Selection of investigations Magnetic resonance imaging Evoked potentials Examination of the cerebrospinal fluid A strategy for the investigation of demyelinating disease 8. The differential diagnosis of multiple sclerosis The spectrum of disorders mimicking multiple sclerosis Diseases that may cause multiple lesions of the CNS and also often follow a relapsing remitting course Systematized central nervous system diseases Isolated or monosymptomatic CNS syndromes Non organic symptoms How accurate is the diagnosis of multiple sclerosis? 9. Multiple sclerosis in the individual and in groups: a conspectus The typical case Isolated syndromes and their outcome: judicious use of investigations and critique of the new diagnostic criteria Co-morbidity and associated diseases Situations in which alternative diagnoses should be considered When to ignore "inconvenient� laboratory results or clinical findings: taking the best position "Pathognomonic� and "un-heard of� features of multiple sclerosis SECTION FOUR: THE PATHOGENESIS OF MULTIPLE SCLEROSIS 10. The neurobiology of multiple sclerosis. Organisation in the central nervous system Development of the central nervous system Macroglial lineages in the rodent and human nervous system Axon-glial interactions and myelination Demyelination Axon degeneration and restoration of function Remyelination 11. The immunology of inflammatory demyelinating disease Multiple sclerosis as an autoimmune disease Immune responses: innate and adaptive T lymphocytes B lymphocytes Autoimmunity and self tolerance in the central nervous system Regulation of central nervous system autoimmune responses Immune reactivity in the central nervous system Pathogenesis of demyelination and tissue damage Peripheral blood biomarkers for multiple sclerosis and disease activity Markers of multiple sclerosis and disease activity in cerebrospinal fluid Conclusion 12. The pathology of multiple sclerosis Introduction Pathological classification of demyelinating diseases The demyelinated plaque Immunopathology of inflammation Demyelination and oligodendroglial damge Remyelination Axonal pathology Grey matter pathology / cortical plaques Astroglia reaction Abnormalities in the "normal� white matter Distribution of lesions in the nervous system Is there evidence for an infectious agent in the lesions of multiple sclerosis? Dynamic evolution of multiple sclerosis pathology Differences between acute relapsing and progressive multiple sclerosis Molecular approaches to the study of the MS lesion: Global profiling of transcriptome and proteome. Association of multiple sclerosis with other diseases Conclusions 13. The pathophysiology of multiple sclerosis Introduction Methods for exploring the pathophysiology of multiple sclerosis Relapsing remitting multiple sclerosis: loss of function due to conduction block Relapsing remitting multiple sclerosis: recovery of function and remission Physiological explanations for other clinical symptoms in multiple sclerosis Permanent loss of function in the context of disease progression Summary SECTION FIVE: THE TREATMENT OF MULTIPLE SCLEROSIS 15. Care of the person with multiple sclerosis General approach to the care of people with multiple sclerosis The early stages of disease: minimal disability The middle stages of disease: moderate disability The later stages of disease: severe disability Guidelines for the management and investigation of multiple sclerosis Conclusion 16. Treatment of the acute relapse The features of active multiple sclerosis The treatment of relapse in multiple sclerosis Other approaches to the treatment of acute relapse Treatment of acute optic neuritis Management of other central nervous system demyelinating disorders Adverse effects of corticosteroids Mode of action of corticosteroids Practice Guidelines 17. The treatment of symptoms in multiple sclerosis and the role of rehabilitation The general principles of symptomatic treatment in multiple sclerosis Disturbances of autonomic function Mobility and gait disturbance Fatigue Disturbances of brain stem function Perturbations of nerve conduction Cognition Visual symptoms Rehabilitation in multiple sclerosis Summary 18. Disease modifying treatments in multiple sclerosis The aims of disease modifying treatment The principles of evidence based prescribing in multiple sclerosis The role of magnetic resonance imaging in clinical trials Drugs that stimulate the immune response Drugs that non-specifically suppress the immune response The beta interferons Molecules that inhibit T cell-peptide binding Specific treatments that target T cells Agents which inhibit macrophages and their mediators Recent miscellaneous treatments Postscript 19: The person with multiple sclerosis: present and future Empirical versus hypothesis driven therapeutics New opportunities for immunological intervention Axon protection; acute and chronic Treatment in special situations Remyelination: Index