Selective peripheral neurolysis using high frequency ultrasound imaging: a novel approach in the treatment of spasticity

BACKGROUND: Chemoneurolysis is used to treat focal spasticity in patients with upper motor neuron syndrome. CASE REPORT: Neurolytic substances (phenol/alcohol) injected nearby/in the main trunk of peripheral nerves can cause not only motor but also cutaneous nerves destruction. The latter is thought to be responsible for considerable side effects such as dysesthesia and paresthesia. During injections, targeting the primary motor branches originating from the main trunk while sparing cutaneous nerves will result in decrease/elimination of these side effects and better clinical improvement. CLINICAL REHABILITATION IMPACT: We suggest that high frequency ultrasound enabling the physician to scan peripheral nerves and their primary branches can be useful to perform this selective peripheral neurolysis in the treatment of spasticity.