Phenol block for cervical dystonia: Effects and side effects

Takeuchi N, Chuma T, Mano Y. Phenol block for cervical dystonia: effects and side effects. Arch Phys Med Rehabil 2004;85:1117-20. Objective To report on the effectiveness and side effects of 2% phenol block in patients with cervical dystonia (CD). Design Case series. Setting A rehabilitation department at a university medical center in Japan. Participants Sixteen patients (11 men, 5 women; mean age ± standard deviation, 43.4±11.2y) with CD. The cause of the CD was unknown, and all cases were refractory to the oral medication and rehabilitation therapy. Intervention Two percent phenol blocks guided by electromyography. Main outcome measures A blind analysis by neurologists of the Tsui score before and after 2 weeks of treatment with phenol block. Side effects were evaluated by another neurologist and patient report. Results There was significant (P=.0002) improvement in neck movement and position, based on a reduced Tsui score, after the phenol block. However, 4 patients had a complication of sensory disturbance of the transverse cutaneous nerve of the neck area. The sensory disturbances decreased gradually and disappeared within 3 months, whereas the effects of the phenol block continued. Conclusions Phenol block can reduce the impact of CD that is refractory to therapy.