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Journal of the Korean Academy of Rehabilitation Medicine 1998;22(3):491-499.
Effects and Side Effects of Chemodenervation According to Neurolytic Agents.
Paik, Nam Jong , Im, Min Sik
1Department of Rehabilitation Medicine, Seoul National University College of Medicine.
2National Rehabilitation Hospital.
신경 용해제에 따른 화학적 신경 용해술의 효과 및 부작용
백남종, 임민식1
서울대학교 의과대학 재활의학교실 및 1국립재활병원 재활의학과
Abstract

Objective
To compare the effects and side effects of chemodenervation according to the neurolytic agents, injection techniques and treatment indications.


Method
One hundred and seventy three cases of chmodenervation were reviewed. They were classified into three groups(phenol, b otulinum toxin, mixed) according to the neurolytic agents and into three groups(nerve trunk block, motor point block, both) according to the injection technique and nine gruoups(cervical dystonia, elbow flexor spasticity, wrist and hand spasticity, hip adductor spasticity, stiff knee gait, ankle plantar flexor spasticity, sustained ankle clonus, rear foot varus, toe clawing) according to the treatment indications. The rate of suboptimal results and side effects was descriptively measured.


Results
1) The suboptimal results were observed in 19% of phenol blocks and 17% of Botulinum toxin injections. But the side effects were more frequently observed in phenol blocks(25%) than Botulinum toxin injections(2%).

2) In terms of phenol injection techniques, a nerve trunk injection was more successful(88%) than a motor point injection(69%). In case of simultaneous injections into the nerve trunk and motor point, the effects were very promising(100%). But the side effects were more frequently observed in the nerve trunk injections(26%) than the motor point injections(12%).

3) In terms of treatment indications, suboptimal results were observed in 44% of stiff knee gaits, 38% of cervical dystonias and 27% of toe clawing cases. Side effects were observed in 33% of toe clawing cases, 25% of sustained ankle clonus cases and 21% of elbow flexor spasticity cases.


Conclusion
The suboptimal results were slightly higher in botolinum toxin injections than in phenol blocks. The side effects were more frequently observed in phenol blocks than in botulinum toxin injections.

Key Words: Chemodenervation, Phenol, Botulinum toxin, Spasticity


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