Book review

Upper Motor Neurone Syndrome and Spasticity: Clinical Management and

Neurophysiology

Edited by Michael P. Barnes and Garth R. Johnson, Cambridge University Press,2001 (317+ix pages)

Spasticity is a common clinical problem that will be encountered by many health

professionals, in a range of different settings from the acute neurosurgical ward to the

community neurodevelopmental clinic. Each professional group will have its own

perspective and its own contribution to make to the care of patients. This book sets out

to encompass all these different aspects of spasticity from basic science to very practical

issues of clinical management with this wide audience in mind.

It begins with a detailed review of the neurophysiology of spasticity. This is actually far

more complicated than most of us who are not specialists in the area will remember.

Fortunately, the chapter is comprehensive and covers the topic very clearly and concisely, in

an understandable way but without oversimplifying the complexities involved. This is

followed by a nice account of methods for the measurement and quantification of spasticity.

There are three chapters on physiotherapy, seating and positioning and orthoses,

splinting and casting. I had wondered whether these would be particularly captivating

for someone like myself, who is not involved in the day-to-day care of patients with

spasticity. However, they actually make interesting and informative reading and I learned

many things which I probably should have known but did not.

There is a succinct review of the drug treatment of spasticity and interesting short

accounts of the place of chemical neurolysis, botulinum toxin and intrathecal baclofen

pumps. Surgical approaches are outlined briefly but fairly comprehensively in a chapter

which covers techniques ranging from cerebellar and spinal cord stimulation to selective

posterior rhizotomy, as well as the role of orthopaedic intervention. The book ends with a

discussion of the particular issues in the management of spasticity in children.

There is a good deal of variability in the length of the chapters with some being quite

short and one or two fairly lengthy. However, they are all well referenced for anyone who

wants to follow up individual topics in more detail. Fortunately, there has been very good

editorial control so that the format and style of the chapters are quite uniform, making the

book much more cohesive and easier to read than many multi-author works. The layout of

the chapters is consistent and nicely designed and the book is attractively produced and

well illustrated.

It has certainly achieved its stated aim of being a guide and source of reference for the

various disciplines concerned in the management of spasticity, combining readability with

a thorough and practical approach. It will be well worth buying for anyone who is directly

PII: S0378 -3782 (01 )00198-0

www.elsevier.com/locate/earlhumdev

Early Human Development 65 (2001) 165–166

involved in the care of patients with spasticity, and many others, like myself, will find it

valuable as an occasional source of reference on specific topics.

Steven White

Department of Clinical Neurophysiology,

Great Ormond Street Hospital for Children,

NHS Trust., Great Ormond Street,

London WC1N 3JH, UK

E-mail address: steven�white66@hotmail.com

Tel.: +44-20-7405-9200

Book review166