• Volume 66 , Number 3
  • Page: 394

Book review

The Peripheral Nervein Leprosy and Other Neuropathies. Antia, N. H. and Shetty, V. P., eds. Delhi: Oxford University Press, 1997. 1295 Rs. Includes index, black/ white and color illustrations/photos, index and three appendices with a select bibliography. Order from Oxford University Press, Great Clarendon Street, Oxford OX2 6DP, U.K.

Leprosy is the most common treatable peripheral neuropathy in the world. Dr. Antia and Dr. Shetty are to be congratulated for editing a timely, comprehensive, and authoritative textbook on the subject of the peripheral nerve in leprosy. The nineteen contributors are well-recognized international authorities ranging from Dr. Antia himself to Dr. Peter Dyck of the Mayo Clinic (U.S.A.), Dr. Dennis Ridley (U.K.), Dr. G. Ramu (India), and Dr. H. Srinivasan (India), to name but a few. The book is divided into five sections: clinical aspects, pathological aspects, management of leprous neuritis, immunologic aspects, and appendices, the last containing summaries of techniques for nerve biopsy, experimental models, and peripheral nerve tissue cultures.

The four chapters on clinical aspects are very well done, with the chapter by Srinivasan and Gupte on quiet nerve paralysis being particularly masterful. There are six chapters in the section on pathological aspects. Shetty provides a very useful review on the structure of the normal peripheral nerve and Jacobs reviews the pathology of nerve damage in general. The chapter on the pathology of nerve damage in leprosy by Shetty and Antia is superb with abundant electron micrographs and photomicrographs, many in color.

Four chapters are devoted to the management of leprous neuritis; traditional approaches to medical, surgical, and rehabilitative management are followed by a chapter by Mistry and Birdi on newer, hypothetical approaches.

There are three chapters in the section on immunological aspects. Mistry reviews work with dissociated Schwann cell cultures in outlining the immunological role of the Schwann cell in leprosy. Anand outlines the failure of nerve growth factor expression in the skin lesions in leprosy and speculates that this may cause a number of the sensory, autonomic, pigmentary and trophic changes seen in the disease. Gerhmann, et al. conclude with a review of the immunopathology of experimental auto-immune neuritis.

This is a definitive collection of information about peripheral nerve involvement in leprosy. It should serve as a valuable reference for leprosy students, practitioners, and researchers for years to come. - RCH

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