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October 1974

Spasticity: The Fable of a Neurological Demon and the Emperor's New Therapy

Arch Neurol. 1974;31(4):217-219. doi:10.1001/archneur.1974.00490400031001

WHY do and why should neurologists treat "spasticity?" These are the strategic rhetorical questions at issue; a detailed critical review of the experimental data of physical and pharmaceutical therapeutic tactics is beyond the scope of this essay.

One must start from the fact that the terms "spastic" and "spasticity" have become such a habitual part of neurological jargon that no one is expected to define them. Dorland's Medical Dictionary (ed 24) defines spastic: "1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward." Spasticity: "A state of increase over the normal tension of a muscle, resulting in continuous increase of resistance to stretching."

In the neurological literature there are at least six varieties of meaning that can be discriminated in context: 1. SpasticityPRR (Proprioceptive Reflex Release).—Quiescent unstimulated muscle with increased proprioceptive reflexes, including, in various degrees, increased phasic

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