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ABSTRACT
BACKGROUND: There are a wide variety of treatments available to reduce the impact of spasticity on the quality of life. Phenol (discovered in 1834) has been used for the treatment of spasticity since the 1960s. Phenol causes nerve destruction (neurolysis), and its effects last from 9 to 18 months.
OBJECTIVE: The primary purpose of this study was to determine the complications rate associated with phenol peripheral nerve blocks as well as motor point blocks.
METHODS: A retrospective study of the all patients treated in our clinic between July 2014 to December 2015. The following variables were analyzed: gender, age, aetiology, sites of nerve block and/ or motor point block, and complications of the procedures.
RESULTS: A total of 54 patients received 86 procedures. There were only 4 (4.6%) complications. These included bruising at the injection site, muscles spasm, neuropathic pain, and muscles weakness. All these complications were transient and resolved spontaneously within few days of the procedure.
CONCLUSION: The study highlights that peripheral phenol nerve blocks and motor point blocks are safe and simple methods for treatment of focal spasticity.
KEY WORDS: Phenol, Nerve Block, Spasticity, Complications
INTRODUCTION
Phenol was discovered in 1834 and has been used for the treatment of spasticity since the 1960s. Phenol causes nerve destruction (neurolysis) by inducing protein precipitation. The nerve-ending regeneration following phenol injection is a very long process (6 months to years). The damage to the nerves tends to block the messages from nerve to a muscle preventing muscle contraction. This leads to the reduction of the spasticity in the treated muscle (motor points block) or muscles supplied by a motor nerve (nerve block).
Spasticity can affect the ability to feed and dress oneself, bladder and bowel control, hygiene, and mobility (e.g. walking and transferring oneself)1. It also predisposes to complications such as pressure sore formation, seating difficulties, and contractures1. The emotional and social impact upon affected individuals can lead to depression, social withdrawal, interruption of lifestyle, and isolation. These often require larger amounts of care and social support.
Treatment of spasticity depends on effects of spasticity on the function as well as posture. The treatment process starts with actively looking for and then treating the triggering factors such as pressure sores, infections, constipation, bladder dysfunctions....