Historical photograph of spinal anaesthesia In 1884 the American neurologist J. L. eases. His discovery, however, marks the Corning, by blocking the neural con onset of the era of regional anaesthesia. It took almost one hundred years until his duction to the hind extremities of a dog by injecting cocaine-solution into the lumbar original idea of "local medication of the vertebral interspace, was the first to per cord" was again reconsidered due to two form spinal (or epidural?) anaesthesia [1]. reasons: At that time, he was unaware of the local I. The discovery of different drug receptors anaesthetic properties of cocaine (dis in the spinal cord made it possible, by in covered in the same year by C. Koller, who trathecal injection (or epidural appli cation, if the drug penetrates the dura), applied cocaine to the eye of one of his pa tients [3]) and did not intend to introduce to alter nociceptive or motor transmis an anaesthetic procedure. Corning's pri sion within the spinal cord. mary aim was the application of drugs in 2. Implantable devices for long-term appli proximity of the central nervous system, i. e. cation of drugs to specific sites of the spinal cord, in order to treat or even heal body, including the spinal spaces, were developed during the 1970's.

Spasticity is a common symptom seen in many neurological conditions notably head injury, spinal cord injury, stroke, cerebral palsy and multiple sclerosis. It is also the dominant feature in a number of rarer conditions such as tropical and hereditary spastic paraparesis (HSP). The fact that it is relevant to many chronic neurological conditions and that the absence of multi-disciplinary input can result in progressive disability, ensures spasticity management is a prominent feature in the current National Service Framework (NSF) for long term neurological conditions. In the future more long-term care for such patients will be done in primary care and the community. It is therefore essential that a multi-disciplinary approach is used with successful liaison between secondary, primary and social care. Optimum management of spasticity is dependent on an understanding of its underlying physiology, an awareness of its natural history, an appreciation of the impact on the patient and a comprehensive approach to minimising that impact which is both multi-disciplinary and consistent over time. Regrettably, these essential requirements are rarely met and consequently, inadequately managed spasticity results in a range of painful and disabling sequelae, which, with the right approach, are, for the most part, preventable. Although there are several excellent publications looking at this area, none are a truly practical guide relevant to all members of the multi-disciplinary team involved in spasticity management. Anyone who has been involved in setting up a new service knows how difficult and how protracted a process this can be and if it has been done before, why reinvent it? The basis of this manual is to collect together the experience and knowledge of such a team who have worked in this area for 10 years now. It pulls together all areas including how to set up and develop a service as well as useful management strategies. On a practical note it includes complete copies of all of our patient information, assessment proformas, protocols for different interventions, nursing care plans and an integrated care pathway for outpatient spasticity management both as hard copy but also on CD-ROM to aid in reproduction. These protocols are of course specific to our team but could easily be adapted for use in other centres. We are not saying this is the 'right' or only way to run a spasticity service and there is certainly room for improvement, but we hope by sharing our experience we can help others to develop their own service thus improving management for all individuals with spasticity.

With the contribution from more than one hundred CNS neurotrauma experts, this book provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma including biomarker studies, experimental models, diagnostic methods, and neurotherapeutic intervention strategies in brain injury research. It discusses neurotrauma mechanisms, biomarker discovery, and neurocognitive and neurobehavioral deficits. Also included are medical interventions and recent neurotherapeutics used in the area of brain injury that have been translated to the area of rehabilitation research. In addition, a section is devoted to models of milder CNS injury, including sports injuries.

Part of the Neurosurgery by Example series, this volume on functional neurosurgery presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication management of common and uncommon disorders. The cases explore the spectrum of clinical diversity and complexity within functional neurosurgery, including essential tremor, thalamotomy, parkinson's disease, epilepsy, dystonia, and more. Each chapter also contains 'pivot points' that illuminate changes required to manage patients in alternate or atypical situations, and pearls for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Functional Neurosurgery is appropriate for neurosurgeons who wish to learn more about a subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.

This practical handbook for clinicians covers pharmacological and non-pharmacological treatment options in neurological rehabilitation.

This is a thorough, practical reference and guide for all health professionals involved in the management of spasticity.

David A. Gelber, MD, and Douglas R. Jeffery, MD, have assembled a much-needed collection of authoritative review articles discussing the pathophysiology of chronic neurologic spasticity and detailing its often complex medical and surgical management. Written by leading experts in neurology and rehabilitation, the book covers physical and occupational therapy, splinting and orthotics, electrical stimulation, orthopedic interventions, nerve blocks, the use of botulinum toxin, and novel treatments such as tizanidine, intrathecal medications, and neurosurgical techniques. The contributors also review coordinated approaches to the treatment of spasticity and specific neurological diseases such as spinal cord injury, multiple sclerosis, stroke, cerebral palsy, and traumatic brain injury.