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241 Countries & Locations using the Neuromuscular Web Site

The Webster's Dictionary: Websites for neurologists

Although it is true that there are a number of outstanding resources on the Net, they are all but obscured in a fog of lesser offerings. We need, at least, a modest beacon to provide some light to guide us. This is the first of a series of regular reviews in Neurology bringing to the readers' attention some neurological Websites that are worth a visit. Medical Websites are basically of two types. Most common is one that has links to other interesting sites and provides an embarkation point for a journey around the Net. The other type contains original information that is worthwhile in its own right. These two varieties of Websites serve very different functions. The first provides a "node" for entry to the useful parts of the Net. The second provides the actual information that is of use to the neurologist.

Neuromuscular Disease Center, Washington University

Alan Pestronk

This is one of the first sites to begin using the true potential of the Web. For generations, the most common method of obtaining information was from the printed page. Early in the development of the Internet, many Websites carried over this idea electronically and presented their content as a succession of pages. Even the name "Webpage" was adopted to cement this idea. This concept of the Web as an electronic page turner is a major problem. A screen of small print is indigestible. Even worse, it prevents the very interaction that is the Web's supreme advantage.

The neuromuscular site is a welcome exception. It presents a huge amount of information in a way that allows the viewer to skim or delve as desired. Much of the content is in tabular form that is easy to understand and a link to a more detailed explanation is always available. It is an admirable mixture of molecular biology with clinical medicine. It is well illustrated-the photographs of muscle biopsies are worth a visit in themselves. As one gets deeper into a topic, links are provided to other worthwhile sources, such as the On-Line Mendelian Inheritance of Man.

Even though the focus of this site is a small subspecialty area, there is enough practical basic science to be useful to the general neurologist. The site is regularly updated.

If there is a criticism, it has to do with the necessity for pruning. So much work is involved in collecting this information and placing it into an acceptable format that it is hard to decide to get rid of it. One might as well amputate one's limbs. This leads sites to grow sometimes akin to an unruly hedge. Some parts of the site may benefit from a critical appraisal and the benefit of the editor's scissors, if not hedgetrimmers. However, such carping is minor. This is one of the best neurological sites on the Net.

Michael H. Brooke, MD

NEUROLOGY 1999;53:441

SITE VISIT: Maladies of Nerve and Muscle

Diseases like multiple sclerosis and amyotrophic lateral sclerosis (ALS) often erode nerves for years before paralyzing or even killing their victims. Providing the latest information on these slow-burn diseases is the Neuromuscular Disease Center, a Web site packed with descriptions of the epidemiology, diagnosis, and treatment of several hundred conditions, from ALS to zoster.

The sober accounts--presented in a terse outline style familiar to physicians--can be viewed by disease, by tissue affected (motor neuron, for example), or even by molecule (such as ion channel, neurotransmitter, or snake venom toxin). Also featured are guides for physicians on how to diagnose the disorders as well as a photo gallery of specimens from normal and abnormal tissue. Researchers will find a rich store of data on the genetics and molecular mechanisms behind the diseases, including external links to protein databases and to the Online Mendelian Inheritance in Man, a virtual encyclopedia of genes and genetic diseases.

Created by Alan Pestronk, a neurologist at Washington University Medical School in St. Louis, the site offers an illustrated primer on neuromuscular disorders geared toward med students and four Wallet WebSites. These are one-page synopses of diseases and diagnostic tests that Pestronk's students like to print out and laminate for use as pocket reference guides.

Science Jan 21, 2000 vol 287


The Neuromuscular Disease Center:
D J Nicholl

Department of Clinical Neurology, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK;

Keywords: neuromuscular disease; the Neuromuscular Disease Center; website

The website of the Neuromuscular Disease Center at Washington University School of Medicine, St Louis, is quite simply an excellent online resource for all issues related to neuromuscular disorders. It is up to date, extensive and highly relevant to any busy clinical neurologist, academic, or basic scientist with an interest in neuromuscular disorders. It is written and edited by Alan Pestronk, who deserves much praise for his efforts. On several occasions, I have found this website of direct use in ways in which traditional methods are more limited (eg links to useful images for lectures or teaching, and assistance with differential diagnosis of rare congenital myopathies to name a few).

Some may dislike the terse bullet point style or the lengthy, unmemorable URL ( However, I suspect that they, like me, will be won over by the huge amount of useful content this site has to offer (differential diagnosis, links to laboratories for testing, and web links to everything from PubMed to patient information). In recent months, the site has improved further with an increasing number of images (eg photos of Duchenne de Boulougne, muscle hypertrophy, and muscle biopsy appearances in the section for Duchenne/Becker muscular dystrophy), which lighten the text somewhat. In summary, this is a site that I have much to commend and little to criticise, I hope you find it as useful as I have.

Journal of Neurology Neurosurgery and Psychiatry 2003;74:93

Internet resources for neurologists
R Al-Shahi and P A G Sandercock
J Neurol Neurosurg Psychiatry 2003;74:699-703

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