Econstudentlog

Peripheral Neuropathy & Neuropathic Pain: Into the light (I)

“Peripheral neuropathy is a common medical condition, the diagnosis of which is often protracted or delayed. It is not always easy to relate a neuropathy to a specific cause. Many people do not receive a full diagnosis, their neuropathy often being described as ‘idiopathic’ or ‘cryptogenic’. It is said that in Europe, one of the most common causes is diabetes mellitus but there are also many other known potential causes. The difficulty of diagnosis, the limited number of treatment options, a perceived lack of knowledge of the subject — except in specialised clinics, the number of which are limited — all add to the difficulties which many neuropathy patients have to face. Another additional problem for many patients is that once having received a full, or even a partial diagnosis, they are then often discharged back to their primary healthcare team who, in many instances, know little about this condition and how it may impact upon their patients’ lives. In order to help bridge this gap in medical knowledge and to give healthcare providers a better understanding of this often distressing condition, The Neuropathy Trust has commissioned a new book on this complex topic.

As well as covering the anatomy of the nervous system and the basic pathological processes that may affect the peripheral nerves, the book covers a whole range of neuropathic conditions. These include, for example, Guillain Barre syndrome, chronic inflammatory demyelinating polyneuropathy, vasculitic neuropathies, infectious neuropathies, diabetic and other metabolic neuropathies, hereditary neuropathies and neuropathies in patients with cancer.”

The stuff above is the part of the amazon book description I decided to include when I added the book to goodreads.

The book is dense. There are a lot of terms defined in the book and a lot of topics covered. Despite being a quite shortish book only a couple hundred pages long (compare for example with related books like this one), it’s still the sort of book which many people might consider using as a reference work (I certainly consider doing that). The author really knows his stuff. According to the website of the European Neurological Society, “The ENS has now become the most prominent society of neurologists on the European Continent with a total of 2300 (including all categories) members from 60 countires [sic] worldwide.” I mention this because five years ago Gérard Said, the author, became the President of the ENS. He’s done/accomplished a lot of stuff besides that, the link has more details about him and what’s he’s done but what it boils down to is that this guy as already mentioned really knows his stuff. I disliked the comment on the front cover of the book that it was Written by one of the world’s leading experts and I at first considered it a decent argument against reading the book, but actually it’s probably both a fair and accurate statement; it seems like this guy really is one of the top guys in his field (I have no clue why someone like this does not have a wikipedia page whereas [random celebrity whose name I don’t know] does – well, I do have a clue, but…).

I don’t find the book particularly hard to read, but I’m frequently looking stuff up and I’ve read textbooks dealing with similar topics before (see e.g. here and here) – maybe I’m underestimating how difficult the book might be to read and understand for someone without much medical knowledge, but I think you should be perfectly able to get through the book without already having a detailed understanding of the neurological system; in my opinion the book is potentially useful for patients as well as medical practitioners, at least if the patient is willing to put in some work. An extensive glossary is included at the beginning of the book, defining most of the terms with which people might be unfamiliar. If you were wondering why I looked up so many words and concepts on wikipedia and other online sources (see below) in spite of the glossary, I should note that this is how I generally read books like this one; wiki or google will often provide additional details compared to the information included in standard glossaries, and often it’s even faster to look up such stuff online than it might be to locate the definition in the book. Another big reason for looking up key terms online was that I decided early on that a link collection like the one included below might be the best way to illustrate here on the blog which kind of content is covered in the book. Regardless of how you decide to look up stuff along the way, you should definitely not skip the definitions included in the glossary before reading the book proper – many of the terms you won’t be able to remember just on account of having read the words and definitions once or twice, but it’s definitely a good idea to have a look even so before moving on; this is probably the first book I’ve read in which the glossary was located at the front of the book instead of somewhere in the back, and it’s not a coincidence that the author decided to organize the book this way.

As a small aside, I thought this might be a reasonable place to add a ‘meta’ comment related to my book posts more generally. I’ve been considering writing slightly shorter posts about the non-fiction books I’m reading/have read; ‘classical posts’ of the kind I’ve written a lot of in the past can easily end up taking four-five hours for me to write and edit, and this means that if I don’t write short posts about the books I may easily end up not blogging them at all. This is an undesirable outcome for me. What I’ve been doing instead lately is to review more books on goodreads than I used to do; the idea being that if I end up not blogging the book, I’ll at least have reviewed it on goodreads. This incidentally means that if you want to keep track of my reading these days and would like to know what I think about the books I’m reading, the front page of this blog is no longer enough; you may need to also pay attention to my activities on goodreads or keep track of my reading via this link (I update that book list very often, usually every time I’ve finished a book). I don’t like to ‘branch out’ like that, but I also don’t like the idea of cross-posting goodreads reviews on the blog, and recently I’ve found it hard to know how to do these things optimally – this is where I’ve ended up. These days I’ll usually add a goodreads review of a non-fiction book quite shortly after I’ve finished the book, especially if I’m not sure if I’ll blog the book later.

Okay, back to the book: I think I’ll limit semi-detailed discussion of the book’s contents to the stuff included about diabetic/metabolic neuropathies, and although I’ve already encountered some relevant content and useful observations on that topic at this point, I have not yet read the chapter devoted to this topic. So you should expect me to post another post about this book some time in the future. I’ve read roughly half the book at this point and as mentioned in an earlier update on goodreads I’m seriously considering giving this book a five star rating. The book has way too much stuff to talk about all of it in detail, so what I’ll do below is to add some links to topics/terms/etc. discussed in the coverage so far which I looked up along the way, to give you a few more details than did the quote at the beginning:

Peripheral neuropathy.
Spinal nerves.
Anterior grey column.
Motor neuron.
Afferent nerve fiber.
Interneuron.
Polyneuropathy.
Nodes of Ranvier.
Myokymia.
Fasciculation.
Neuromyotonia.
Syringomyelia.
Charcot–Marie–Tooth neuropathy.
Guillain–Barré syndrome.
Acute motor axonal neuropathy.
Dysautonomia.
POEMS syndrome.
Monoclonal gammopathy of undetermined significance.
Plasmacytoma.
Vasa nervorum.
Vasculitic neuropathy.
Granulomatosis with polyangiitis.
Churg-Strauss syndrome.
Mononeuritis Multiplex.

October 12, 2015 - Posted by | books, diabetes, medicine, meta

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