eMJA: A much-needed handbook on motor neurone disease

The motor neurone disease handbook

Matthew C Kiernan, editor. Sydney: MJA Books, 2007 (vii + 230 pp). ISBN 978 0 9775786 3 4

The diagnosis and management of a patient with motor neurone disease (MND) is, in my opinion, the hardest task in clinical neurology. The patient and family often want an early diagnosis at a time when it is not wise to be too dogmatic. When the diagnosis is finally given and the prognosis discussed, there is an understandable period of despair, which the neurologist tries to ease with regular follow-up visits. Despite the lack of a truly effective therapy, there have been significant advances in the ongoing care of patients with MND, which have been greatly facilitated by the concept of the multidisciplinary team.

Matthew Kiernan runs a multidisciplinary MND clinic at the Prince of Wales Hospital in Sydney and has been involved in the development of the Australian MND Registry. He is well qualified to edit this handbook and has assembled a distinguished group of local and international contributors who have provided a comprehensive account of the current status of research and clinical care of patients with MND.

All chapters are of a uniformly high standard and the style and content are reader-friendly. As a neurologist I found the chapter by Rod Mackenzie, a colleague with MND, not only very instructive but particularly inspiring.

This is a much-needed handbook for neurologists, general practitioners, allied health professionals, and patients and their families. To my knowledge there is no comparable publication and it comes at an important time for those in the MND field. The advent of riluzole, which in controlled trials has shown a capacity to prolong survival, has not only provided some hope for patients and their families, but has focused the attention of neurologists on the need to improve overall care in this disease, similar to the effect of interferon-β in multiple sclerosis more than a decade ago.