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Intramuscular neurolysis with alcohol to treat post-stroke finger flexor spasticity
1Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore.
Objective:
To evaluate the effectiveness of intramuscular neurolysis with alcohol for the treatment of finger flexor spasticity in individuals with stroke.
Design:
Case series.
Setting:
Outpatient clinic of a tertiary rehabilitation facility.
Subjects:
Thirty patients with a mean age of 60.2 years and post-stroke duration of 8.3 months with finger flexor spasticity.
Interventions:
Intramuscular neurolysis or motor point blocks of the finger flexors of the hemiplegic upper extremity with 50% ethyl alcohol.
Main Outcome Measures:
The severity of spasticity as measured by the Modified Ashworth Scale (MAS) and the passive range of motion of the proximal interphalangeal joints of the second to fifth digits.
Results:
The mean baseline MAS score was 4.0 +/- 0.5 and this improved to 2.0 +/- 0.6, 2.2 +/- 0.6 and 2.6 +/- 0.6 at four weeks, three months and six months post neurolysis respectively. The gains in range of motion were 18.5 +/- 6.7, 17.5 +/- 6.4 and 14.9 +/- 4.8 degrees at four weeks, three months and six months post neurolysis respectively. These improvements were statistically significant (p < 0.05). Two subjects developed temporary dysesthetic pain of the forearm and palm.
Conclusion:
Intramuscular neurolysis with alcohol provides good relief of finger flexor spasticity in hemiplegic individuals.