STEP 2: Spasticity Live Course - April 26-27 in Rosemont, IL-Case-based Discussion: Diplegic Cerebral Palsy Leading to Lower Extremity Neurolysis

Case-based Discussion: Diplegic Cerebral Palsy Leading to Lower Extremity Neurolysis

Pdf Summary

The document discusses the use of phenol for interventional spasticity management, providing a historical background, early and current applications, clinical benefits, and techniques. Phenol, a denaturant of protein, is used in peripheral applications to destroy nerves non-selectively, leading to muscle deactivation. It is commonly mixed with glycerin for a slow diffusion pattern and duration of benefit ranging from 3-9 months. The document highlights phenol's role in managing spasticity in conditions like cerebral palsy, offering an alternative or supplement to botulinum toxin injections. Techniques for neurolysis using phenol involve E-stim guidance, ultrasound localization, and potential adverse effects such as dysesthesias and muscle discomfort. The importance of precautionary measures like drawing back before injection and avoiding aggressive stretching post-injection is emphasized. Additionally, the document suggests the use of diagnostic blocks with lidocaine or bupivacaine when uncertain. It also mentions the importance of combining phenol treatment with other modalities like splinting and serial casting for effective spasticity management. Ultimately, the document provides insight into the application, benefits, techniques, and precautions associated with using phenol for interventional spasticity management.

Keywords

Phenol

Interventional spasticity management

Peripheral nerve destruction

Glycerin

Cerebral palsy

Neurolysis techniques

E-stim guidance

Ultrasound localization

Adverse effects

Precautionary measures