By Dr. D. Jeanmonod (auth.), Marc P. Sindou M.D., I. Richmond Abbott M.D., Yves Keravel M.D. (eds.)
"Spasticity is without doubt one of the most common sequelae of neurological ailment and through the previous few years many advances were made within the therapy of this criticism through useful neurosurgery. This booklet ... will attract neurosurgeons, orthopaedic surgeons and neurologists among others.” Annals of the Royal university of Surgeons of England
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Additional info for Neurosurgery for Spasticity: A Multidisciplinary Approach
The reflex activity does not arise simultaneously at each level, but is carried out from distal to proximal site and appears earlier for somatic centers than for vegetative ones (Maury 1981). Spasticity occurs later in complete cervical lesions than in dorsal ones, and earlier and more intensely in incomplete lesions. 2) Monosynaptic disorganization. The stretch reflex is dominant on the adductor and anti-gravity muscle groups, rarely giving a major disability. The main problem occurs later on, due to a disorganization of the reciprocal inhibition causing interference with antagonist muscles during movement (Maury 1981, Young et al.
Secondly, several methods for evaluation of segmental mechanisms of spasticity are available. And thirdly, supraspinal influences on spinal cord reflex mechanisms can be studied. Clinical neurophysiological methods for documentation and quantification of clinical phenomena If continuous, as in case of muscle vibration or during passive limb movements, muscle stretch evokes a tonic stretch reflex (Hagbarth and Eklund 1966, Lance et al. 1973), while brief taps to muscle tendons abruptly stretch the intramuscular spindle receptors and evoke so called phasic stretch reflexes.
4) The chronology of the lesion is important in two ways: age of patients at the onset of spasticity, as with the special pattern of the spastic child related to 30 cerebral palsy; time course of the acquisition of the lesion, especially in adults. Spastic hemiplegia A hemispheric lesion in an adult, following a stroke or trauma, can result in spasticity developing over a varying interval (Rondot 1968). "Pyramidal hypertonicity", investigated by Foix and Chavany as early as 1924, appears initially in the arms and the lower face.