Phenol block for cervical dystonia: effects and side effects.

OBJECTIVE

To report on the effectiveness and side effects of 2% phenol block in patients with cervical dystonia (CD).

DESIGN

Case series.

SETTING

A rehabilitation department at a university medical center in Japan.

PARTICIPANTS

Sixteen patients (11 men, 5 women; mean age +/- standard deviation, 43.4+/-11.2y) with CD. The cause of the CD was unknown, and all cases were refractory to the oral medication and rehabilitation therapy.

INTERVENTION: Two percent phenol blocks guided by electromyography.

MAIN OUTCOME MEASURES: A blind analysis by neurologists of the Tsui score before and after 2 weeks of treatment with phenol block. Side effects were evaluated by another neurologist and patient report.

RESULTS

There was significant (P=.0002) improvement in neck movement and position, based on a reduced Tsui score, after the phenol block. However, 4 patients had a complication of sensory disturbance of the transverse cutaneous nerve of the neck area. The sensory disturbances decreased gradually and disappeared within 3 months, whereas the effects of the phenol block continued.

CONCLUSIONS

Phenol block can reduce the impact of CD that is refractory to therapy.