Naoyuki Takeuchi1, Takayo Chuma, Yukio Mano. 1. Department of Rehabilitation Medicine, Hokkaido University Graduate School of Medicine, North 14 West 5, Sapporo 060-0814, Japan. naoyuki@med.hokudai.ac.jp
Abstract
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.
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.
Authors: Pinky Agarwal; Richard Barbano; Henry Moore; Marc Schwartz; Aleksej Zuzek; Marjan Sadeghi; Atul Patel Journal: Front Neurol Date: 2022-06-30 Impact factor: 4.086