Intramuscular neurolysis with alcohol to treat post-stroke finger fiexor spasticity

Abstract

Objective: To evaluate the effectiveness of intramuscular neurolysis with alcohol for the treatment of finger fiexor spasticity in individuals with stroke. Design: Case series. Setting: Outpatient clinic of a tertiary rehabilitation facility. Subjects: Thirty patients with a mean age of 60.2 years and post-stroke duration of 8.3 months with finger fiexor spasticity. Interventions: Intramuscular neurolysis or motor point blocks of the finger fiexors of the hemiplegic upper extremity with 50% ethyl alcohol. Main outcome measures: The severity of spasticity as measured by the Modified Ashworth Scale (MAS) and the passive range of motion of the proximal interphalangeal joints of the second to fifth digits. Results: The mean baseline MAS score was 4.0 ± 0.5 and this improved to 2.0 ± 0.6, 2.2 ± 0.6 and 2.6 ± 0.6 at four weeks, three months and six months post neurolysis respectively. The gains in range of motion were 18.5 ± 6.7, 17.5 ± 6.4 and 14.9 ± 4.8 degrees at four weeks, three months and six months post neurolysis respectively. These improvements were statistically significant ( p < 0.05). Two subjects developed temporary dysesthetic pain of the forearm and palm. Conclusion: Intramuscular neurolysis with alcohol provides good relief of finger fiexor spasticity in hemiplegic individuals.