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Medicine - Neurology | Spasticity - Mechanisms and Management


Mechanisms and Management

Thilmann, Alfred F., Burke, David J., Rymer, William Z. (Eds.)

Softcover reprint of the original 1st ed. 1993, XIV, 463 pp. 125 figs., 12 tabs.

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Over the past 10-20 years there has been an explosion of work on the disturbance of motor control that is manifested as "spasticity." This work has been based on new insights from animal experiments into the basis of normal motor control and the development of experimental techniques that could be used in patients with neurological disturbances. For this reason, on the initiative of Alfred Thilmann, the editors of this volume organized a workshop on spasticity, held in Essen, Germany, in November, 1992. The intention of the meeting was to bring together leading scientists in an atmosphere that would generate discussion and hopefully consensus and ideas for future work. The attendance was restricted and deliberately selective, with a mix of basic scientists, clinical scientists and practicing clinicians. The product of their presentations and deliberations is this volume. The book is organized in the same sequence as the workshop, so that the discussion sessions could be summarized by the appropriate chairman.

Content Level » Professional/practitioner

Keywords » Neurology/Clinical Neurophysiology - Physiology - Physiotherapy/Physical Therapy - Rehabilitation

Related subjects » Medicine - Neurology - Neuroscience

Table of contents 

Spasticity: History, Definitions, and Usage of the Term.- I Descending Control of Movement.- Organisation of Cortico-motoneuronal Projections from the Primary Motor Cortex: Evidence for Task-Related Function in Monkey and in Man.- Investigation of Descending Motor Pathways in Man.- Propriospinal Transmission of Voluntary Movement in Humans.- The Site of Activation of the Corticospinal System by Transcranial Magnetic and Electrical Stimulation of the Human Mortor Cortex.- Plasticity of the Human Motor Cortex.- Discussion Summary.- Discussion Summary.- II Disturbance of Voluntary Movement.- The Role of the Corticospinal Tract in Spasticity Studied by Magnetic Brain Stimulation.- Do Rapidly Conducting Ipsilateral Corticospinal Pathways Contribute to Recovery in Adult Hemiplegia?.- Strength Changes in Hemiparesis: Measurements and Mechanisms.- Factors Underlying Abnormal Posture and Movement in Spastic Hemiparesis.- Disturbances of Voluntary Arm Movement in Human Spasticity: The Relative Importance of Paresis and Muscle Hypertonia.- Spastic Movement Disorder: Similarities and Differences in Children and Adults.- Hyper-reflexia and Disordered Voluntary Movement.- Discussion Summary.- Discussion Summary.- III Spinal Pathophysiology: Animal Models.- Regulated Properties of Motoneurons and Primary Afferents: New Aspects on Possible Spinal Mechanisms Underlying Spasticity.- Functional Properties of the Neuromuscular System and Force Gradation.- Development of an Animal Model for the Study of Spinal Spasticity.- Monoaminergic Inhibitory Control of Spinal Interneurons.- Discussion Summary.- IV Reflex Disturbances in Spasticity: Movement Studies.- Pathological Changes in Spastic Muscle Reflexes Evoked by Passive Stretch or Tendon Taps.- Spastic Paresis: Reflex Activity and Muscle Tone in Elbow Muscles During Passive and Active Motor Tasks.- Discussion Summary.- V Reflex Disturbances in Spasticity: Electrophysiological Studies.- Methodological Problems in the Hoffmann Reflex Study of Spasticity.- Signs of the Upper Motoneuron Syndrome in Relation to Soleus Hoffmann Reflex Tests.- Pathophysiological Mechanisms of Spasticity at the Spinal Cord Level.- Dynamics of Reflex Excitability Following Intrathecal Baclofen Administration in Patients with Severe Spastic Syndromes.- Task-Dependent Spinal Inhibition in Spastic Hemiplegia.- Late Flexion Reflex in Paraplegic Patients: Evidence for a Spinal Stepping Generator.- Kinematics of the Cat Hindlimb After Spinal Cord Hemisection.- Discussion Summary.- Discussion Summary.- VI Treatment and Rehabilitation.- Spasticity of the Lower Urinary Tract: Therapeutic Strategies.- New Developments in the Medical Treatment of Spasticity.- Muscle Relaxant Action of Excitatory Amino Acid Antagonists.- Effect of Intrathecal Baclofen on Monosynaptic Reflex in Man.- Comparison of Cyproheptadine, Clonidine and Baclofen on the Modulation of Gait Pattern in Subjects with Spinal Cord Injury.- Neurophysiological Mechanisms of Spasticity Modification by Physiotherapy.- Is Rehabilitation Effective in Spastic Syndromes?.- Discussion Summary.

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