Intramuscular neurolysis with alcohol to treat post-stroke finger flexor spasticity.

OBJECTIVE

To evaluate the effectiveness of intramuscular neurolysis with alcohol for the treatment of finger flexor 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 flexor spasticity.

INTERVENTIONS: Intramuscular neurolysis or motor point blocks of the finger flexors 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 flexor spasticity in hemiplegic individuals.