Phenol block of the tibial nerve in the hemiplegic patient

Selective blocks of the tibial nerve with aqueous solution of 5% phenol, after localization of the nerve by electrical stimulation, were performed in 30 patients with acquired hemiplegia for treatment of severe spasticity of the foot plantar flexors and ankle clonus. Ankle clonus disappeared in all patients and resistance to passive stretch was reduced substantially immediately after the procedure; orthotic fitting and ambulation training then were possible. Longterm followup (averaging 12.9 months) showed the gait to be improved and spasticity decreased in all patients; there were no indications for further treatment of plantar flexor spasticity. Fixed equinus deformity was prevented in all cases. The only significant complication was the development of paresthesias in eight patients (26.6%) The simplicity of the procedure, the functional results observed immediately, its longlasting effect, and the lack of serious complications, warrant its more widespread use in the treatment and prevention of deformities in the spastic foot of the hemiplegic patient. However, there should be further study about prevention of paresthesias, which occurred in a significant percentage of patients in this study.