Garland D E, Lilling M, Keenan M A
Arch Phys Med Rehabil. 1984 May;65(5):243-5.
The motor points of spastic wrist and finger flexors were identified using a nerve stimulator. These motor points were injected percutaneously with either a 3% or 5% aqueous solution of phenol in 11 patients with brain injury. The effectiveness of the blocks was assessed by recording the resting angle of the wrist, active extension of the wrist, and passive extension of the wrist--first with the fingers flexed and then with the fingers extended. The blocks were repeated once in two patients and twice in one patient for return of muscle tone which interfered with hand function. Relaxation of muscle tone persisted for up to two months following the injections. The resting angle of the wrist improved a mean of 25 degrees. Active wrist extension improved an average of 30 degrees. The changes in wrist measurements represent the effects of different processes: 1) the neurolytic effect of the phenol block; 2) improvement in the neurologic status of the patient; and 3) regeneration of the motor end plate. This procedure is an effective method of temporarily controlling spasticity and allowing functional hand training while neurologic recovery is occurring.
使用神经刺激器确定痉挛性腕部和手指屈肌的运动点。在11例脑损伤患者中，经皮向这些运动点注射3%或5%的苯酚水溶液。通过记录腕部的静息角度、腕部主动伸展和被动伸展情况（先是手指屈曲时，然后是手指伸展时）来评估阻滞的效果。有两名患者因肌肉张力恢复影响手部功能而重复进行了一次阻滞，一名患者重复进行了两次阻滞。注射后肌肉张力的松弛持续了长达两个月。腕部的静息角度平均改善了25度。腕部主动伸展平均改善了30度。腕部测量的变化代表了不同过程的影响：1）苯酚阻滞的神经溶解作用；2）患者神经状态的改善；3）运动终板的再生。该方法是在神经恢复过程中暂时控制痉挛并允许进行功能性手部训练的有效方法。
