What is the role of neurolysis in the treatment of hemiplegic shoulder pain?

Updated: Feb 08, 2019
  • Author: Robert Gould, DO; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Elbow flexor spasticity is a common poststroke complication of the flexor synergy pattern. Regular stretching of this muscle group has been suggested as being effective for only a very short period of time before the spastic shortening recurs.

Kong and Chua found that neurolysis (with 50% ethyl alcohol) of the musculocutaneous nerve can significantly improve elbow flexion spasticity and PROM, without affecting strength. These improvements were maintained during the 6-month follow-up period. A small percentage of patients even experienced improved walking balance, decreased finger flexor spasticity, and relief of shoulder pain. The only significant complication reported was a temporary dysesthetic pain in the distribution of the lateral antebrachial cutaneous nerve, a branch of the musculocutaneous nerve. [56]


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