Neurolysis of the musculocutaneous nerve with alcohol to treat poststroke elbow flexor spasticity

• Published in: Archives of physical medicine and rehabilitation Vol. 80; no. 10; pp. 1234 - 1236
• Main Authors: Kong, Keng-He, Chua, Karen S.G.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.1999; Elsevier
• Subjects: Biological and medical sciences; Diseases of the nervous system; Elbow Joint - innervation; Elbow Joint - physiopathology; Ethanol; Female; Follow-Up Studies; Gait; Hemiplegia; Humans; Male; Medical sciences; Middle Aged; Motor Skills; Muscle Spasticity - diagnosis; Muscle Spasticity - etiology; Muscle Spasticity - physiopathology; Muscle Spasticity - therapy; Musculocutaneous Nerve; Nerve Block - methods; Pain - etiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Range of Motion, Articular; Severity of Illness Index; Stroke - complications; Time Factors; Treatment Outcome; Human; Nervous system diseases; Stroke; Spasticity; Cardiovascular disease; Muscle tonus alteration; Alcohol; Musculocutaneous nerve; Cerebral disorder; Vascular disease; Neurolysis; Striated muscle disease; Treatment; Flexor muscle of the elbow; Central nervous system disease; Complication; Neurological disorder; Cerebrovascular disease
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/S0003-9993(99)90021-7

Objective: To evaluate the effectiveness of alcohol in neurolysis of the musculocutaneous nerve for the treatment of elbow flexor spasticity in individuals with a stroke. Design: Case series. Setting: Outpatient clinic of a tertiary rehabilitation facility. Participants: Twenty patients with a mean age of 62.8 years and poststroke duration of 12.3 months with elbow flexor spasticity. Intervention: Musculocutaneous nerve block of the hemiplegic upper extremity with 50% ethyl alcohol. Outcome Measures: The severity of spasticity as assessed by the modified Ashworth scale (MAS) score and the elbow passive range of motion (PROM). Results: The mean baseline MAS score was 3.7 ± 0.6, and this improved to 1.7 ± 1.0, 2.0 ± 0.8, and 2.1 ± 0.8 at 4 weeks, 3 months, and 6 months postneurolysis, respectively. The elbow PROM was 87.3° ± 20.2°, 104.3° ± 20.1°, 103.8° ± 18.9°, and 101.6° ± 19.7°, respectively. These improvements were statistically significant ( p < .05). Four subjects had concomitant improvement of finger flexor spasticity and another four had relief of shoulder pain. Three subjects developed temporary dysesthetic pain over the lateral forearm. Conclusion: Neurolysis of the musculocutaneous nerve with alcohol provides good relief of elbow flexion spasticity in hemiplegic individuals.