THE DIAGNOSIS AND TREATMENT OF ATHETOSIS AND DYSTONIA

¹ The Neurological Unit, Boston City Hospital, and the Department of Neurology, Harvard Medical School

1. A sharp distinction should be made between the various types of "spasticity", as each requires its own particular type of treatment.

2. The chief types of "spasticity" are hemiplegia (including monoplegia and diplegia), paralysis agitans and the associated rigidity, and the athetoid-dystonic group.

3. Of neurosurgical operations for athetosis, cortical excision may be considered in cases in which one arm alone is affected and is already useless.

4. Section of the extrapyramidal tracts in the spinal cord is a procedure now wisely used for athetosis. It affords moderate to satisfactory relief of abnormal movements in the majority of cases. It can be combined with the Foerster-Dandy operation for torticollis when indicated.

The dangers of the operation have been greatly diminished by the use of proper precautions.

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