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Rehabilitation Practice and Science

Translated Title

酚劑肌內神經阻斷術於處理肌肉痙攣之成效

Abstract

In patients with upper motor neuron dieases. they usually present with variable degrees of spasticity. Moderate and severe degree of spasticity will interfere with patients' function and cause great difficulty in daily care. The incidence of musculoskeletal deformity which requires surgical correction is also higher in patients with severe spasticity. There were 43 patients with upper motor neuron diseases, which included 34 patients with cerebral palsy. 5 patients with cerebrovascular diseases and 2 patients with head injury. Phenol intramuscular neurolysis were performed in the muscle groups with moderate to severe spasticity that interferes with function and daily care in these patients. 149 muscles were injected, included 57 gastronemius. 50 hip adductors. 28 medial hamstrings. 6 biceps, 1 triceps, 8 wrist and finger flexors and 2 posterior tibials. For more accurate localization of the muscles to be injected, we used general anesthesia or chloral hydrate PR in patients with cerebral palsy. To evaluate effect and duration of phenol intramuscular neurolysis. preblock and post-block periodically assessment of range of motion of joints, degree of spasticty, deep tendon reflex and ankle clonus were done in each patients. Also. any side effect after block or improvement in motor function were investigated. The follow-up period ranged from 1 to 7 months. The duration of effect is 6 months on the average. The improvement in ROM of Joints has lassted even longer. One third of patients showed improvement in motor function. Four patients still needed orthopedic surgery after block due to coincidence with joints contracture. Three and six patients complained of local swelling and tenderness within 2 days after block respectively. 6 muscles developed local induration and tenderness 1 week after block. Their symptoms subsided 2 to 3 weeks after conservative management. No systemic side effects were noted in our study.

Language

Traditional Chinese

First Page

45

Last Page

51

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