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Spasticity: mechanism, measurement and management
432
nOOK rEViEWS
during H ~ ~avag~, but onJy a siightpref¢r~,icefor glucose. From these and prior studks, independent control of liquid sekcted versus amount drunk is p~opo~d. Metabolic, biochemical and el¢ctrophysiological factors are freshly evaluated by Nicolaldis, who finds that R.Q. increased within one minute of tbe initiation of a m¢~.l. However, confounding effects of muscular activity are a problem. Tongue stimulation with saccharin or sw rose but not water led to a hyperglycemia within 3-5 minutes. These changes are considered "pre-adaptive" immediate effects of food, which '*...anticipate the po~:al'~orptive effects of ini~mta". Rewoduction of diaiprarus and photomicrographs is excellent. Although the price of this symposium is "strong", and its bindin8 weak, most r~_rchers and clinicians interested in hun~er, thirst or internal cbemore* ceptwn will wish to have a copy. Bruce P, HaLPERN
Cornell University, Ithaca, 3'.Y. 14830 (U.S.A./ Electroenceph. e::n. Neurophysiol., 1970, 28:431-432
Spm~t¢/~: medumbm, mtmm'emem and u u m q e m e a t . E. h (C. C, " i l l o ~ , ~ l ~ ' i ~ d d , m,, 1969, 130 p., $7.75). This volume is a well-organized monograph to which an extensive bibliography has been appended. The Foreword to the book would lead one to believe that the monowaph deals with controlled experiments or drug trials in the treatment of spasticity; such is not the case. The first chapter, which deals with the anatomical and physiological substrata of spasticity, is a straightforward presentation of current concepts. It is a general review of the subject, rather than personal work in the field, worth the attention of those unfamiliar with the function of the gamma motor system, pyramidal and extrapyramidai systeml. Th= disctumion is presented fairly, with equal consideration devoted to alternate explanations, so that there is little to criticize here. Tbe second, rather brief, chapter concerns the clinical aspects of spasticity and beginsabruptly, without transition from the first chapter. Little distinction is made between rapid, phasic and slower ("static") movement, or between various monosynaptic and polysynsptic reflexes involved in hypertonic phenomena. Although there is a distinction between three varieties of hypertonus, cortical ("cerebrai"), *'subcortical" and "spin-'" spa ' ~ t y , one ;~ unsure whether this distinction b ~ on clinical diffezen¢¢s in the periphera!l pattern of the hypertonus or is m e ~ a tautoloMc dmUnction based primarily on clinico-
The third chapte~, d.-~measurement of spasticity, is a review of various methods that are available to document and/or quantify the hylXxtonic pheno~non, l ~ , ~ . n again prtaents the problem fairly when he concludes that no one method is superior to any otbex amon$ mech~icai methods, doctromyolgraphy, H reflex studies and various clinical maneuva~.
In the fourth chapter, on management, the discussion is divided among pharmacologic ~gents eB',,~tiv~ ..'~ spast~ity, physical therapy and various methods of operative intervention, such as chemical desu~ction by alcohol and phenol, rhizotomy, cordotomy and orthopedic procedures. Alth,)ulp~ possibly they are not emphasized sutficiently, many valid clinical axioms can be foam/ in this rather general discussion. It is perhaps unfortunate thai, in order to present the subject in a brief monosraph, the author could not have directed mote attention to a detailed and pointed evaluation of the indications for each management method. As a general discusdon, however, this chapter is admirable. The format of the book makes it easy to follow, it can be recommended to those unfamiliar with the topic in general or to those who wish to review it in broad Iloneral terms. ;{ ~G-"-|d .-.~; ~o~m -~"ful for the nem'uchemist or neurophysiolo~st, since it contains little in the way ot ori~nal data, details of clinical drug trials or animal experimentation.
JOEL BRUMUK Del~rtmcm of Neurology, Northwestern University School of Medicine, Chicago. Ill. 60611 (U.S.A.)
Electroenceph. clan. Veurophy.ffol., 19#10, 28:432
m,m.cdm~m,
i
vmcmmL
" ~ - . - ' F. ~ (YEn G ~ t ~ ~ 1969, 256 p., M 41.00).
VmCq, , k L
This monograph deals with combined ekctrophysiological and behavioural research on t ~ rat. The behavioux of rats is well studied, since much of contemporary psls:holo i ~ rests on it, On the other hand there are not too many electrophysiological studies performed with this animal. Therefore the combination used in the work r~xwted in this volume is valuable. Chronically imphmted corlicai and hippocampal electrodc~ were used together with electrodes in the olfactory bulb (monitoring of respiration) and a motimeter for registration of motor activity. Conditioning and extinction of avoidance, archive and alimentary reflexes are studied, tolether with other phenomena like startle reflexes, orien~n| resction~ ;rod habituation. Besides the bac.kwound activity evoked potentials,"photicaily evoked after-discharges" and "photically evoked recruiting" ate described in a somewhat arbitrary terminology. During ail changes all indicators underv~nt three phases: a disturbia8 phase, an edapultion phase and a phase of well adapted hetmviour, it ~ intcr,~ting but no/convincing that in this "phase-thtaxy" all electrophysioiolical criteria and such diverse phenomena as conditioning, orienting reactions and habituation get some kind of explanation by the authors.
M . ~ Dept. of Hyt~e~e of the Umle,er~y. Vie~a ( A ~ i a )
Electroenceph. din. Neurophy$tol., 1970, 28:432
nOOK rEViEWS
during H ~ ~avag~, but onJy a siightpref¢r~,icefor glucose. From these and prior studks, independent control of liquid sekcted versus amount drunk is p~opo~d. Metabolic, biochemical and el¢ctrophysiological factors are freshly evaluated by Nicolaldis, who finds that R.Q. increased within one minute of tbe initiation of a m¢~.l. However, confounding effects of muscular activity are a problem. Tongue stimulation with saccharin or sw rose but not water led to a hyperglycemia within 3-5 minutes. These changes are considered "pre-adaptive" immediate effects of food, which '*...anticipate the po~:al'~orptive effects of ini~mta". Rewoduction of diaiprarus and photomicrographs is excellent. Although the price of this symposium is "strong", and its bindin8 weak, most r~_rchers and clinicians interested in hun~er, thirst or internal cbemore* ceptwn will wish to have a copy. Bruce P, HaLPERN
Cornell University, Ithaca, 3'.Y. 14830 (U.S.A./ Electroenceph. e::n. Neurophysiol., 1970, 28:431-432
Spm~t¢/~: medumbm, mtmm'emem and u u m q e m e a t . E. h (C. C, " i l l o ~ , ~ l ~ ' i ~ d d , m,, 1969, 130 p., $7.75). This volume is a well-organized monograph to which an extensive bibliography has been appended. The Foreword to the book would lead one to believe that the monowaph deals with controlled experiments or drug trials in the treatment of spasticity; such is not the case. The first chapter, which deals with the anatomical and physiological substrata of spasticity, is a straightforward presentation of current concepts. It is a general review of the subject, rather than personal work in the field, worth the attention of those unfamiliar with the function of the gamma motor system, pyramidal and extrapyramidai systeml. Th= disctumion is presented fairly, with equal consideration devoted to alternate explanations, so that there is little to criticize here. Tbe second, rather brief, chapter concerns the clinical aspects of spasticity and beginsabruptly, without transition from the first chapter. Little distinction is made between rapid, phasic and slower ("static") movement, or between various monosynaptic and polysynsptic reflexes involved in hypertonic phenomena. Although there is a distinction between three varieties of hypertonus, cortical ("cerebrai"), *'subcortical" and "spin-'" spa ' ~ t y , one ;~ unsure whether this distinction b ~ on clinical diffezen¢¢s in the periphera!l pattern of the hypertonus or is m e ~ a tautoloMc dmUnction based primarily on clinico-
The third chapte~, d.-~measurement of spasticity, is a review of various methods that are available to document and/or quantify the hylXxtonic pheno~non, l ~ , ~ . n again prtaents the problem fairly when he concludes that no one method is superior to any otbex amon$ mech~icai methods, doctromyolgraphy, H reflex studies and various clinical maneuva~.
In the fourth chapter, on management, the discussion is divided among pharmacologic ~gents eB',,~tiv~ ..'~ spast~ity, physical therapy and various methods of operative intervention, such as chemical desu~ction by alcohol and phenol, rhizotomy, cordotomy and orthopedic procedures. Alth,)ulp~ possibly they are not emphasized sutficiently, many valid clinical axioms can be foam/ in this rather general discussion. It is perhaps unfortunate thai, in order to present the subject in a brief monosraph, the author could not have directed mote attention to a detailed and pointed evaluation of the indications for each management method. As a general discusdon, however, this chapter is admirable. The format of the book makes it easy to follow, it can be recommended to those unfamiliar with the topic in general or to those who wish to review it in broad Iloneral terms. ;{ ~G-"-|d .-.~; ~o~m -~"ful for the nem'uchemist or neurophysiolo~st, since it contains little in the way ot ori~nal data, details of clinical drug trials or animal experimentation.
JOEL BRUMUK Del~rtmcm of Neurology, Northwestern University School of Medicine, Chicago. Ill. 60611 (U.S.A.)
Electroenceph. clan. Veurophy.ffol., 19#10, 28:432
m,m.cdm~m,
i
vmcmmL
" ~ - . - ' F. ~ (YEn G ~ t ~ ~ 1969, 256 p., M 41.00).
VmCq, , k L
This monograph deals with combined ekctrophysiological and behavioural research on t ~ rat. The behavioux of rats is well studied, since much of contemporary psls:holo i ~ rests on it, On the other hand there are not too many electrophysiological studies performed with this animal. Therefore the combination used in the work r~xwted in this volume is valuable. Chronically imphmted corlicai and hippocampal electrodc~ were used together with electrodes in the olfactory bulb (monitoring of respiration) and a motimeter for registration of motor activity. Conditioning and extinction of avoidance, archive and alimentary reflexes are studied, tolether with other phenomena like startle reflexes, orien~n| resction~ ;rod habituation. Besides the bac.kwound activity evoked potentials,"photicaily evoked after-discharges" and "photically evoked recruiting" ate described in a somewhat arbitrary terminology. During ail changes all indicators underv~nt three phases: a disturbia8 phase, an edapultion phase and a phase of well adapted hetmviour, it ~ intcr,~ting but no/convincing that in this "phase-thtaxy" all electrophysioiolical criteria and such diverse phenomena as conditioning, orienting reactions and habituation get some kind of explanation by the authors.
M . ~ Dept. of Hyt~e~e of the Umle,er~y. Vie~a ( A ~ i a )
Electroenceph. din. Neurophy$tol., 1970, 28:432