Phenol and alcohol blocks in the treatment of spasticity [Spastisite Tedavisinde Fenol ve Alkol Bloklari]

Peripheral nerve blocks, which have been known as an effective way of reducing localized spasticity are performed by injection of a chemical agent into the muscles or close to the nerve supplying the muscles where overactivity is most disabling. Local anesthetics, phenol and alcohol are the agents used for the local treatment of spasticity, in addition to botulinum toxin. In practice, use of phenol and alcohol blocks requires considerable experience and skill. This article will focus on the clinical studies addressing phenol and alcohol blocks, mechanism of action, rationale for use, technique of administration and potential side effects

Electrophysiological assessment of sexual dysfunction in spinal cord injured patients

WOS: 000245758400005PubMed ID: 16773036Study design: Survey. Objectives: To determine associations between sexual dysfunctions and electrophysiological examinations of the genital system in spinal cord injured patients. Setting: Ege University Hospital, Izmir, Turkey. Methods: In total, 25 patients ( 17 men, eight women) who were out of the spinal shock period were examined. Neurological levels were determined according to the American Spinal Injury Association ( ASIA) impairment scale. Data about erection, ejaculation and vaginal lubrication were obtained via inquiry forms. Bulbocavernosus re. ex ( BCR), pudendal somatosensorial evoked potentials ( pSEP) and perineal sympathetic skin responses ( pSSR) were recorded by an electromyographer unaware of the sexual state or neurological level of the patient. Results: BCRs could be obtained from all patients with lesion levels above the sacral centre. A significant association was found between re. ex erection and BCR positivity, while psychogenic erection was shown to have a significant association with the preservation of pSSR in men. Despite the lack of statistical significance due to the small sample size of the women examined, a similar association with lubrication was observed. Ejaculation and orgasm were not shown to be significantly associated with any electrophysiological examination. However, ejaculation was preserved in all men with a lesion level below T12 and with positive pSSR. There was no significant relationship between pSEP and sexual functions. The relationship between the existence of sacral sensation and pSEP positivity was statistically significant. Conclusion: This study has proved that BCR and pSSR have an important role in the estimation of the remaining sexual function in spinal cord injured patients