Abstract
Objective: To evaluate the effectiveness of alcohol in neurolysis of the musculocutaneous nerve for the treatment of elbow flexor spasticity in individuals with a stroke. Design: Case series. Setting: Outpatient clinic of a tertiary rehabilitation facility. Participants: Twenty patients with a mean age of 62.8 years and poststroke duration of 12.3 months with elbow flexor spasticity. Intervention: Musculocutaneous nerve block of the hemiplegic upper extremity with 50% ethyl alcohol. Outcome Measures: The severity of spasticity as assessed by the modified Ashworth scale (MAS) score and the elbow passive range of motion (PROM). Results: The mean baseline MAS score was 3.7 ± 0.6, and this improved to 1.7 ± 1.0, 2.0 ± 0.8, and 2.1 ± 0.8 at 4 weeks, 3 months, and 6 months postneurolysis, respectively. The elbow PROM was 87.3° ± 20.2°, 104.3° ± 20.1°, 103.8° ± 18.9°, and 101.6° ± 19.7°, respectively. These improvements were statistically significant ( p < .05). Four subjects had concomitant improvement of finger flexor spasticity and another four had relief of shoulder pain. Three subjects developed temporary dysesthetic pain over the lateral forearm. Conclusion: Neurolysis of the musculocutaneous nerve with alcohol provides good relief of elbow flexion spasticity in hemiplegic individuals.
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