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ICC Sydney

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Ultrasound-guided common and uncommon nerve blocks with alcohol for spasticity management

Session outline

This workshop will provide education on the utility, and practice of ultrasound-guided nerve blocks for spasticity management.

Neurolysis of peripheral nerves can be performed to treat regional spasticity. A neurolytic agent such as alcohol (60-65% ethyl alcohol or 6-10% phenol) can be used to mobilize joints negatively affected by spasticity.

Alcohol neurolysis offers several advantages when it is compared to botulinum toxin (BTX) injections which has been widely accepted for spasticity management: It provides i) a longer lasting effect; ii) enable to cover diffuse spastic muscles when it combined with BTX that has limitation by the guideline of safe dosage; iii)  is less costly than BTX. By using the same techniques, nerve can also be blocked with local anesthetic injection to differentiate between spasticity and contracture of injected muscles.

Ultrasound has advantage to facilitate the identification of nerves under direct electric stimulation, allow real-time monitoring needle path and injection solution spread, and reduce procedure complications. It is important for physiatry to understand and use ultrasound as a clinical tool, and learn nerve block technique as spasticity treatment option.

At the conclusion of this workshop, participants will learn to delineate the indications of relevant nerve blocks for spasticity of the upper and lower extremities; participants will be able to attain the detailed knowledge of anatomy and sonoanatomy for relevant nerve blocks and will be able to outline the pearls and pitfalls of ultrasound-guided injection for nerve blocks for treating spasticity.

Learning outcomes

Information coming soon

Target audience

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