Treatment of Acquired Muscle Spasticity Using Phenol Peripheral Nerve Blocks

Abstract

The use of phenol motor nerve blocks is advantageous in the early period of acquired spasticity (ie, that occurring following traumatic brain injury or incomplete spinal cord injury), when increased muscle tone is often the most severe. Because acquired spasticity is dynamic and usually improves slowly, a temporary treatment method used to ameliorate increased muscle tone is desirable. Phenol nerve infiltration provides a temporary motor nerve block that lasts for weeks or months. It allows passive limb mobilization in a comprehensive rehabilitation program that attempts to prevent fixed soft tissue contractures. Permanent or irreversible methods such as operative tendon lengthening, muscle release or recession, or neurectomy are usually best delayed until the spasticity has become static, when the need for surgical correction becomes more firmly indicated, and outcomes of operative intervention are more predictable. Although phenol nerve blocks were initially administered at the spinal cord level to control spasticity, the potential side effects have caused a loss of popularity of this method of administration. The safer and more common use of phenol infiltration at the peripheral nerve level is now more accepted for brain injury and spinal cord injury patients. This report reviews the indications, current concepts, and development of the different methods used to administer phenol nerve blocks. Comparisons to other methods to control spasticity are discussed.

Jumpy stump syndrome treated by targeted muscle reinnervation (TMR): a case report and review of the literature

“…Phenol injections have been used as a method to control spastic muscles by impeding signals to overstimulated nerves. 33,34 One case report detailed the use of phenol injections for "jumpy stump syndrome". 24 A 38year-old man with bilateral transfemoral amputations experienced painful "jumpy stump syndrome" for about 1 yr post-operatively.…”

“…These reports show that both Botulin Toxin A and B may have clinical utility in reducing pain and spasms associated with “jumpy stump syndrome”. Phenol injections have been used as a method to control spastic muscles by impeding signals to overstimulated nerves 33,34 . One case report detailed the use of phenol injections for “jumpy stump syndrome” 24 .…”

Proposta Contemporânea Do Tratamento Da Espasticidade Em Pacientes Neurológicos Adulto: Uma Revisão Sistemática

“…Este, é indicado em casos de espasticidade grave que não respondem aos tratamentos conservadores habituais. Tendo como vantagem provocar uma ablação específica do tônus de longa duração 13 . Diante do exposto, este estudo tem como objetivo descrever as propostas contemporâneas para o tratamento da espasticidade em adultos, por meio de uma revisão sistemática.…”