Maybe someone will follow us?! Always again, I used to

repeat to myself and to the others that, when approaching the patient, always the following rules should be respected: watch, listen and use your own common sense to evaluate what you observe; analyse why the symptoms occur in a concrete case; include the therapy in the logic of symptom development; continue to follow the patient and ask questions of yourself and of your colleagues; consult the literature; find the differences; ask again and again what else could be done … and the solutions will appear unexpectedly. Key words: Spasticity, cramps, neuromyotony Introduction In neurology, we consider the muscle tonus increased Inhibitors,research,lifescience,medical if, by passive movement of extremities or parts thereof, a resistance occurs, in spite of the patient being fully relaxed. If we cannot passively change the position of Inhibitors,research,lifescience,medical an extremity at all, we are observing contracture. By elimination of the heightened tonus, and especially contracture, the movement is freed. Many decades ago, as a young neuropsychiatry specialist, I started to worry about how to help the patients with increased muscle tonus conditions. Inhibitors,research,lifescience,medical A summary of the different clinical conditions and their pathogenesis, diagnosis and treatment are listed in Table 1. Table 1. Features differentiating already used terms. Increased muscle tonus as a consequence

of central nervous pathways damage These were mainly patients with spasticity or rigidity of the Parkinsonian type. When attempts to suppress spasticity by phenol blockades (1) did not lead to the desired effect, I went in 1968 to H.F. Hufschmidt in Frankfurt-Main, Germany, on a DAAD scholarship, to become acquainted with MEK inhibition Hufschmidt’s method of lowfrequency electrostimulation in spasticity. Upon my return, the Neuropsychiatry Inhibitors,research,lifescience,medical Department of Rebro Hospital acquired Hufschmidt’s machine and we started applying it following his scheme, beginning with spastic patients (2). I tried using it later with other indications. Those were mainly characteristic of the Parkinsonian syndrome, and we Inhibitors,research,lifescience,medical achieved very nice effects in a number

of cases (3). In the meantime, l-dopa came to Croatia and Adenylyl cyclase the positive effects on rigor were now faster and easier achievable, so the electrostimulation for Parkinson’s Disease lost its significance. As a side effect of electrotherapy we noticed improvement in retention and incontinence of urine, and even in sexual function. We elaborated Hufschmidt’s scheme of muscle stimulation and achieved desired results by an indirect approach (4). The method survived in the Lipik and Varaždin Rehabilitation Centres and in the Urologic Department of the Rebro Hospital in Zagreb. Increased muscle tonus due to peripheral nervous system and muscle damage With the development of the Centre for Neuromuscular Diseases in Zagreb, patients with increased muscle tonus due to nerve or muscle disease started to arrive much more frequently.