J Korean Acad Rehabil Med.  2007 Jun;31(3):371-374.

Sonographically Guided Musculocutaneous Nerve Phenol Block for Elbow Flexor Spasticity: Case report

• Bang IK
• Kim C
• Ahn JK
• Park YK
• Reu HW
• Jung IT

Abstract

Seven hemiplegic stroke patients suffering elbow flexor spasticity were selected for musculocutaneous nerve (MN) blocks. The MN was identified at the proximal 1/3 area on anteromedial surface of upper arm at supine position. An injectable monopolar EMG needle electrode was inserted into MN under real time ultrasonography. The 7% phenol solution was injected 0.2 ml at a time into MN until biceps brachii and brachialis muscle contractions were completely blocked at a maximum of 5 mA electrical stimulation. The total dose of injected phenol solution was 1.2~2.2 ml. We examined modified Ashworth scale (MAS) of elbow flexor and elbow angle at the standing position. In all the subjects, MAS was decreased and elbow angle was increased after nerve block. Ultrasonography guidance makes it exact to identify MN and to inject neurolytic solution to target. It can lead minimal complications by using the least dosage of neurolytic drug.

Keyword

Musculocutaneous nerve; Sonography; Spasticity

MeSH Terms

Arm
Elbow*
Electric Stimulation
Electrodes
Humans
Muscle Contraction
Muscle Spasticity*
Musculocutaneous Nerve*
Needles
Nerve Block
Phenol*
Stroke
Supine Position
Ultrasonography
Phenol