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Phenol neurolysis for relieving intermittent involuntary painful spasm in upper motor neuron syndromes: a pilot study
Tarek S Shafshak1, Alaa Mohamed-Essa
1Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria University, Alexandria, Egypt. tshafshak@yahoo.com
Objective:
The aim of this study was to assess the efficacy of phenol neurolysis in relieving intermittent attacks of involuntary painful muscle spasm in patients with upper motor neurone syndromes.
Design:
Case series.
Patients:
Nineteen patients with intermittent involuntary painful muscle spasm of one of the following muscles: extensor hallucis longus (n=13), psoas major (n=3), tensor fascia lata (n=1) or vastus lateralis (n=2).
Methods:
Phenol neurolysis was performed for the target muscles using a Teflon-coated stainless-steel injection needle (connected to a block stimulator). The change in frequency and severity of intermittent involuntary painful muscle spasm was assessed 1, 2, 8 and 24 weeks after neurolysis.
Results:
The frequency and severity of intermittent involuntary painful muscle spasm decreased in all patients for 24 weeks following neurolysis. Analgesic drugs were not required for the intermittent involuntary painful muscle spasm and no serious side-effects were observed following neurolysis.
Conclusion:
Phenol neurolysis gave promising results in treating intermittent involuntary painful muscle spasm in patients with upper motor neurone syndromes.
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