Abstract
Jang SH, Ahn SH, Park SM, Kim SH, Lee KH, Lee ZI. Alcohol neurolysis of tibial nerve
motor branches to the gastrocnemius muscle to treat ankle spasticity in patients with
hemiplegic stroke. Arch Phys Med Rehabil 2004;85:506–8.
Objective
To evaluate the effectiveness of alcohol neurolysis of tibial nerve motor branches
to the gastrocnemius muscle for the treatment of ankle plantarflexor spasticity in
patients with hemiplegic stroke.
Design
Case series.
Setting
Inpatient and outpatient clinics in the rehabilitation department of a university
hospital.
Participants
Twenty-two patients with hemiplegic stroke (mean age, 48y).
Interventions
Motor branch block (MBB) of the tibial nerve to the gastrocnemius muscle with 50%
ethyl alcohol in cases of spastic ankle.
Main outcome measures
The severity of spasticity was assessed using the Modified Ashworth Scale (MAS) score
of ankle plantarflexor, clonus score of the ankle, and the passive range of motion
(PROM) of ankle dorsiflexion.
Results
The MAS score was reduced in 17 (77%) of 22 patients during the 6-month follow-up,
and spasticity reappeared at the level of the pre-MBB state in 5 patients (23%). The
mean values of all parameters were significantly improved. The changes of mean values
from the pre-MBB to the 6-month post-MBB stage were as follows: MAS score, 3.3±0.7
versus 1.7±1.1; clonus score, 1.6±0.7 versus 0.4±0.8; and PROM, 17.1°±13.0° versus
28.6°±4.7°. No serious complications were observed during the 6-month follow-up period.
Conclusions
MBB of the tibial nerve to the gastrocnemius muscle is an effective and safe procedure
for relieving localized spasticity of the ankle plantarflexors.
Keywords
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References
- Selective neurotomy of the tibial nerve for treatment of the spastic foot.Neurosurgery. 1988; 23: 738-744
- Current uses of open phenol nerve block for adult acquired spasticity.Clin Orthop. 1982; May: 217-222
- The use of open phenol blocks to the motor branches of the tibial nerve in adult acquired spasticity.Foot Ankle. 1991; 11: 219-221
- Interrater reliability of a modified Ashworth scale of muscle spasticity.Phys Ther. 1987; 67: 206-207
- Clinical assessment of spasticity in spinal cord injury.Arch Phys Med Rehabil. 1996; 77: 713-716
- Anatomy of the motor branches of tibial nerve for motor branch block.in: Jang S.H. Park S.M. Proceedings of the 29th Annual Meeting Korean Academy of Rehabilitation Medicine. Medrang, Seoul2001 (Oct 25–26 2001)
- Alcohol neurolysis of the sciatic nerve in the treatment of hemiplegic knee flexor spasticity.Arch Phys Med Rehabil. 2000; 81: 1432-1435
- Neurolysis of the musculocutaneous nerve with alcohol to treat poststroke elbow flexor spasticity.Arch Phys Med Rehabil. 1999; 80: 1234-1236
- Dilute ethyl alcohol.Arch Phys Med Rehabil. 1976; 57: 233-237
- Clinical and functional outcome after alcohol neurolysis of the tibial nerve for ankle-foot spasticity.Brain Inj. 2001; 15: 733-739
- Peripheral nerve block with phenol in the management of spasticity.JAMA. 1967; 200: 1155-1157
Article info
Footnotes
☆Supported by the Neuroscience Association of Yeungnam University Medical Center.
☆No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated.
Identification
Copyright
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
