While the main symptoms of movement disorders are clearly defi ned, patients do not necessarily respect the arbitrary grouping of symptoms that have traditionally defi ned recognized diseases. Hence, it is refreshing to see a new text that starts with an agnostic view of the main symptoms and describes how to focus thinking to arrive at the best diagnosis. Not only that, but the authors recognize that the boundaries of currently recognized movement disorders are sometimes arbitrary and that a person presenting with a disorder of movement might well also have what is now considered a neuromuscular disorder. Thus, this book extends beyond what is ordinarily covered in a movement disorder text. Following the logic described here, a physician can take a patient with a set of unique symptoms; carefully assess the history, signs, and laboratory examinations; and come up with a probable cause or even etiology – and then there is advice about therapy. In regard to the boundaries of movement disorders, the fi eld has been constantly expanding. When we started, it was restricted to disorders of the basal ganglia, often improperly called extrapyramidal disorders. Spasticity, a disorder of the pyramidal tract, was excluded, as was ataxia. These disorders, clearly affecting movement, have gradually been incorporated. Moreover, as the classic movement disorder, Parkinson’s disease has been recognized to have non-motor features, now features such as dementia and orthostatic hypotension are necessary to keep in mind. In this sense, the term movement disorders is somewhat changing its meaning. The diagnostic tools are therefore constantly expanding, and movement disorders now include all neurological aspects of these conditions and not only the disorder of movement. This book is forward looking in this regard. An important theme spreading through movement disorders these days, as it should through all of medicine, is that diseases must be described in two axes, symptoms and etiologies. Patients with any set of symptoms, even the traditional parkinsonian triad of bradykinesia, rigidity, and tremor, may have different etiologies. And, conversely, a specifi c etiology can lead to a variety of groups of symptoms. Disease is multifactorial and there is not a one-to-one match of symptoms and etiologies. Hence, the value of this book’s approach is in starting with symptoms and then thoughtfully moving to etiology. The knowledge base of movement disorders is rapidly expanding, and this book is right up to date. There are many illustrations, algorithms, and tables which make the reading easier. Altogether, this book is a fi ne contribution that should be welcomed by practitioners as well as residents and fellows.
Disorders of Movement: a guide to diagnosis and treatment
MORGANTE, FRANCESCA
2016-01-01
Abstract
While the main symptoms of movement disorders are clearly defi ned, patients do not necessarily respect the arbitrary grouping of symptoms that have traditionally defi ned recognized diseases. Hence, it is refreshing to see a new text that starts with an agnostic view of the main symptoms and describes how to focus thinking to arrive at the best diagnosis. Not only that, but the authors recognize that the boundaries of currently recognized movement disorders are sometimes arbitrary and that a person presenting with a disorder of movement might well also have what is now considered a neuromuscular disorder. Thus, this book extends beyond what is ordinarily covered in a movement disorder text. Following the logic described here, a physician can take a patient with a set of unique symptoms; carefully assess the history, signs, and laboratory examinations; and come up with a probable cause or even etiology – and then there is advice about therapy. In regard to the boundaries of movement disorders, the fi eld has been constantly expanding. When we started, it was restricted to disorders of the basal ganglia, often improperly called extrapyramidal disorders. Spasticity, a disorder of the pyramidal tract, was excluded, as was ataxia. These disorders, clearly affecting movement, have gradually been incorporated. Moreover, as the classic movement disorder, Parkinson’s disease has been recognized to have non-motor features, now features such as dementia and orthostatic hypotension are necessary to keep in mind. In this sense, the term movement disorders is somewhat changing its meaning. The diagnostic tools are therefore constantly expanding, and movement disorders now include all neurological aspects of these conditions and not only the disorder of movement. This book is forward looking in this regard. An important theme spreading through movement disorders these days, as it should through all of medicine, is that diseases must be described in two axes, symptoms and etiologies. Patients with any set of symptoms, even the traditional parkinsonian triad of bradykinesia, rigidity, and tremor, may have different etiologies. And, conversely, a specifi c etiology can lead to a variety of groups of symptoms. Disease is multifactorial and there is not a one-to-one match of symptoms and etiologies. Hence, the value of this book’s approach is in starting with symptoms and then thoughtfully moving to etiology. The knowledge base of movement disorders is rapidly expanding, and this book is right up to date. There are many illustrations, algorithms, and tables which make the reading easier. Altogether, this book is a fi ne contribution that should be welcomed by practitioners as well as residents and fellows.File | Dimensione | Formato | |
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