New York, Cambridge University Press, 1998. For much of their length, peripheral nerves are protected against the immune system by tight capillary endothelial junctions and perineurium. However, this protection is only relative. Lymphocytes, immunoglobulins, complement components, viruses, and toxins can gain access to motor nerves at their termination in skeletal muscle and to sensory nerves at the level of the dorsal-root ganglion. The clinical presentations of immune-mediated peripheral nervous system disorders include symmetric distal polyneuropathy, selective involvement of one or more peripheral nerves, and pure dysfunctions of autonomic nerves or neuromuscular junctions.
Diagnosis can be straightforward.
Measurements of nerve conduction velocity serve as a helpful extension of the clinical examination, making it possible to distinguish between demyelinative disorders and axonal disorders. Immunological and Infectious Diseases of the Peripheral Nerves is a valuable resource for clinicians involved in the diagnosis of neuromuscular disorders and care of patients with these diseases. The chapters are by experts and have been carefully and consistently formulated to cover the clinical, pathophysiologic, and therapeutic aspects of essentially all the known immunologic and infectious diseases affecting the peripheral nervous system. Despite the many authors, there is very little redundancy. The illustrations are, in general, well chosen, though the reproduction of histologic figures suffers somewhat from the paper stock and the lack of color.