Interneurones and rigidity of spinal origin

Gelfan, Samuel; Tarlov, I. M.

doi:10.1113/jphysiol.1959.sp006214

Cited by 123 publications

(35 citation statements)

References 39 publications

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“…17 In animal models, the duration of the ischemia is related to histological damage and motor recovery. 18 We agree with Iseli et al 19 that the severity of the initial neurological injury constitutes the main factor, which determines the prognosis in traumatic spinal cord injuries. Waters et al 20,21 pointed out that less than 1% of paraplegics reach ambulatory ability in the community if they do not present motor contraction in their lower limbs within a month after injury.…”

Section: Neurological Prognosissupporting

confidence: 51%

Computed tomographic angiography of anterior spinal artery in acute cervical spinal cord injury

Zhang

Zhou

et al. 2013

Spinal Cord

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Section: Neurological Prognosissupporting

confidence: 51%

Computed tomographic angiography of anterior spinal artery in acute cervical spinal cord injury

Zhang

Zhou

et al. 2013

Spinal Cord

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“…Tarlov then excised the cystic lumbar cord and noted histologically a paucity of interneurons relative to motor neurons. This finding corresponded to his earlier experimental observation on dogs with hind limb hypertonus secondary to interneuronal destruction (Gelfan and Tarlov, 1959). The complete failure to relieve flexion spasms in one patient with multiple sclerosis can be attributed to the fact that in multiple sclerosis, unlike spinal injuries, the increased muscle tone of the legs may be largely the result of a loss of interneurons in the cord.…”

Section: Discussionsupporting

confidence: 73%

Percutaneous lumbar rhizotomy for spasms in paraplegia

Turnbull

1983

Spinal Cord

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Summary. Twenty-one patients with myelopathy causing uncontrollable spasms of the legs underwent percutaneous lumbar rhizotomy. There were two groups: active, otherwise healthy people with spinal lesions whose rehabilitation was hampered by spasms of flexion or extension of the hips and knees; and a second group of hospitalised, debilitated paraplegic patients with unhealing decubitus ulcers.Fourteen of the 16 active patients had excellent results initially, as did all five of th� patients with pressure sores.Six have undergone repeat procedures in 7 to IS months for recurrences of some component of the spasms. All have had at least minor recurrences. Of six patients with significant sensory preservation pre-operatively, four found the resulting numbness disturbing and two did not achieve good relief from the spasms.The procedure is recommended when uncontrollable spasms interfere with rehabilitation or healing of pressure sores in patients with spinal lesions with complete motor and sensory loss.

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“…The centromedullary disease led to alterations of spinothalamic pathways by loss of inhibitory interneurons with overbalanced excitatory motor neuron function. 11,32 Electrophysiological studies are an essential component of clinical diagnostics. The SSEP and MEP recordings can provide quantification and segmental orientation of morphological and functional lesions of the spinal cord and thoracic column pathways, but the results remain under debate.…”

Section: Discussionmentioning

confidence: 99%

A new concept in the electrophysiological evaluation of syringomyelia

Röser¹,

Ebner²,

Liebsch³

et al. 2008

SPI

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Object The current neurophysiological assessment of syringomyelia is inadequate. Early-stage syringomyelia is anatomically predisposed to affect decussating spinothalamic fibers that convey pain and sensation primarily. Silent periods have been proven to be a sensitive tool for detecting alterations in this pathway. Methods Thirty-seven patients with syringomyelia were included in this prospective study. Routine electrophysiological measurements were applied including somatosensory evoked potential (SSEP) and motor evoked potential (MEP) recordings for all extremities. The silent periods were recorded from the pollicis brevis muscle, and electrical stimuli were applied to the ipsilateral digiti II. To establish baseline values, the authors had 28 healthy controls undergo monitoring. Sensitivity and specificity values were statistically evaluated according to the main clinical symptoms (paresis, dissociative syndrome, and pain). Results All control individuals had normal silent periods in voluntarily activated muscle. In syringomyelia patients, the affected limb showed pathological silent periods with all symptoms (sensitivity 30–50%). Pain was the most specific symptom (90%), despite SSEP and MEP values that were within the normal range. Conclusions Silent period testing is a sensitive neurophysiological technique and an invaluable tool for preoperative assessment of syringomyelia. Silent periods are associated with early dysfunction of thin myelinated spinothalamic tract fibers, even when routine electrophysiological measurements still reveal normal values. Conduction abnormalities that selectively abolish the silent periods can distinguish between hydromyelia (a physiologically dilated central canal) and space-occupying syringomyelia.

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Interneurones and rigidity of spinal origin

Cited by 123 publications

References 39 publications

Computed tomographic angiography of anterior spinal artery in acute cervical spinal cord injury

Computed tomographic angiography of anterior spinal artery in acute cervical spinal cord injury

Percutaneous lumbar rhizotomy for spasms in paraplegia

A new concept in the electrophysiological evaluation of syringomyelia

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