Spastic movement disorder

This review deals with the neuronal mechanisms underlying spastic movement disorder, assessed by electrophysiological means with the aim of first, a b etter understanding of the underlying pathophysiology and second, the selec tion of an adequate treatment. For the patient usually one of the first sym ptoms of a lesion within the central motor system represents the movement d isorder, which is most characteristic during locomotion in patients with sp asticity. The clinical examination reveals exaggerated tendon tap reflexes and increased muscle tone typical of the spastic movement disorder. However , today we know that there exists only a weak relationship between the phys ical signs obtained during the clinical examination in a passive motor cond ition and the impaired neuronal mechanisms being in operation during an act ive movement. By the recording and analysis of electrophysiological and bio mechanical parameters during a functional movement such as locomotion, the significance of, for example, impaired reflex behaviour or pathophysiology of muscle tone and its contribution to the movement disorder can reliably b e assessed. Consequently, an adequate treatment should not be restricted to the cosmetic therapy and correction of an isolated clinical parameter but should be based on the pathophysiology and significance of the mechanisms u nderlying the disorder of functional movement which impairs the patient.