Department of Physical Medicine and Rehabilitation, Keimyung University College of Medicine, Taegu, Korea.
NeuroRehabilitation. 2012;31(4):373-7. doi: 10.3233/NRE-2012-00806.
Proper management of elbow spasticity is important in stroke rehabilitation. We investigated the effect and safety of ultrasound guided alcohol neurolysis of the MC nerve for controlling elbow flexor spasticity in hemiparetic stroke patients. Ten hemiparetic stroke patients with severe elbow spasticity were recruited for this study. We identified the MC nerve using ultrasound and performed neurolysis with 35% ethyl alcohol. The severity of spasticity was assessed using the modified Ashworth scale (MAS) score and associated reaction (AR) of elbow flexor. During the 2 months follow-up period, both MAS score and AR were reduced in all 10 patients. Before treatment, the mean MAS score was 3.4 ± 0.5, and this improved to 0.1 ± 0.3 immediately post-neurolysis, 1.8 ± 1.0 at one month and 1.9 ± 0.8 at two months (p < 0.001). The mean change of AR of the affected elbow was significantly decreased, from 75.2 ± 30.0° before neurolysis to 24.8 ± 21.3° immediately post-neurolysis, 35.5 ± 24.7° at 1 month and 40.8 ± 25.1° at 2 months (p < 0.001). Ultrasound guided MC nerve block is an effective and safe procedure for relieving localized spasticity of the elbow flexor.
肘部痉挛的恰当管理在脑卒中康复中非常重要。我们研究了超声引导下 MC 神经酒精神经溶解术治疗偏瘫脑卒中患者屈肘肌痉挛的效果和安全性。本研究纳入了 10 例严重肘部痉挛的偏瘫脑卒中患者。我们使用超声识别 MC 神经，并使用 35%的乙醇进行神经溶解术。使用改良 Ashworth 量表（MAS）评分和屈肘肌的相关反应（AR）评估痉挛程度。在 2 个月的随访期间，所有 10 例患者的 MAS 评分和 AR 均降低。治疗前，MAS 评分的平均值为 3.4 ± 0.5，神经溶解术后即刻降至 0.1 ± 0.3，1 个月时为 1.8 ± 1.0，2 个月时为 1.9 ± 0.8（p < 0.001）。受影响肘部的 AR 平均值明显降低，从神经溶解术前的 75.2 ± 30.0°降至即刻的 24.8 ± 21.3°，1 个月时为 35.5 ± 24.7°，2 个月时为 40.8 ± 25.1°（p < 0.001）。超声引导下 MC 神经阻滞是缓解屈肘肌局部痉挛的有效且安全的方法。
