To the Editor.—The recent editorial on spasticity by Dr. Landau in the October Archives (31:217, 1974) was lucid and enlightening but incomplete.
Although Dr. Landau "fails to see how spasticity limits fine hand and finger movements," it is an everyday observation that some afflicted individuals who have a fairly strong grip cannot use it because of inability to extend the hand and fingers before grasping. The excess of flexor tone that is typical in some hemiplegics is probably a release phenomenon, that is, a disinhibition; and this seems to me an instance in which positive symptoms are responsible for a deficit by occluding normal function.
But there is a more fundamental omission in the editorial. In addition to "negative" symptoms from "destruction of pertinent tissue" and also "positive" symptoms attributable to release from inhibition, there are also "negative" symptoms attributable to release from facilitation. The removal of this facilitation
Bogen JE. Dysfunction From Defacilitation. Arch Neurol. 1975;32(6):421–422. doi:10.1001/archneur.1975.00490480087013
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