By Dr. D. Jeanmonod (auth.), Marc P. Sindou M.D., I. Richmond Abbott M.D., Yves Keravel M.D. (eds.)
ISBN-10: 3709167086
ISBN-13: 9783709167083
ISBN-10: 3709173884
ISBN-13: 9783709173886
"Spasticity is among the most common sequelae of neurological sickness and through the previous few years many advances were made within the remedy of this criticism through useful neurosurgery. This booklet ... will entice neurosurgeons, orthopaedic surgeons and neurologists among others.” Annals of the Royal university of Surgeons of England
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Extra info for Neurosurgery for Spasticity: A Multidisciplinary Approach
Example text
Evolution of the handicap depends on the central lesion: in cases of progressive recovery, the first voluntary movements are facilitated by spasticity (Twitchell 1951), and must be carefully identified during the assessment. In cases of permanent deficit, spasticity remains associated with negative signs such as weakness, disturbed higher cortical functions, and other abnormalities of motor control like syncinetic movements, grasping reflex, rigidity, athetosis. Functional evaluation requires a multidisciplinary approach, the most important point being to identify the dominant harmful pattern.
II. The effect of the descending brain stem pathway. Brain 91: 1-36 Maury M (1981) La paraplegie chez I'adulte et chez l'enfant. Flammarion: 1-733 Ohanna F (1987) Plasticite de l'unite motrice chez Ie paraplegique: approche histo-enzymologique, neurophysiologiqu et biomecanique: Memoire d'etudes et de recherche en biologie humaine. Faculte Medecine Montpellier Guin 1987), pp 1-105 Rondot P (1968) Etudes cliniques et physiopathologiques des contractures. , consequences fonctionnelles et problemes therapeutiques.
Later, with a delay implicating a phase of neural reorganization, there occurs a phase of increased intrinsic spinal activity with both exaggeration of proprioceptive and afferent flexor reflexes, confirmed by mono- and polysynaptic reflex clinical studies (Hultborn and Malmstem 1983). Comparing experimental and clinical data, one can deduce that magnitude and associated responses of spasticity depend mainly on the site of the causal lesion. 3) Extensive and combined lesions cause associated neurological impairment: these deficits mainly motor weakness, combined with spasticity in the agonist/ antagonist coupled muscle groups are the main cause of functional disability (Hoffer 1976).