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Phenol Neurolysis for the Management of Shoulder Spasticity in Early Recovery From Traumatic Brain Injury: A Case

Manuel F Mas1, Craig DiTommaso2, Sheng Li1

  • 1Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, and TIRR Memorial Hermann, Houston, TX.

PM & R : the Journal of Injury, Function, and Rehabilitation
|June 23, 2018
PubMed

Insights

Phenol neurolysis effectively treated spasticity and pain in a teenage traumatic brain injury patient. Early intervention with phenol injections led to significant functional recovery and improved limb positioning.

Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Pain Management

Background:

  • Traumatic brain injury (TBI) can lead to secondary complications like spasticity.
  • Spasticity and associated pain significantly impair functional recovery after TBI.
  • Current management strategies for post-TBI spasticity often require long-term approaches.

Observation:

  • A 16-year-old male developed severe spasticity, shoulder girdle dysfunction, and pain post-TBI.
  • Phenol (6%) neurolysis was administered to the axillary and radial nerves at 10 weeks post-injury.
  • Ultrasound guidance and electrical stimulation were utilized for precise phenol delivery.

Findings:

  • Immediate reduction in triceps spasticity and shoulder pain was observed post-phenol injection.
  • Gradual improvement in shoulder girdle complex and elbow joint positioning occurred within 2 weeks.
  • The patient demonstrated enhanced functional recovery following the intervention.

Implications:

  • Early phenol neurolysis may be a viable strategy for managing spasticity in the acute recovery phase after TBI.
  • This case highlights the potential for targeted neurolysis to improve functional outcomes and reduce pain.
  • Further research is warranted to explore the long-term efficacy and safety of early phenol neurolysis for TBI-related spasticity.

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