Intrathecal phenol: an old treatment revisited

Purpose. Severe bilateral leg spasticity can cause severe symptoms and reduced quality of life in affected individuals. It is often unresponsive to treatment. The objective of this study was to review the effectiveness of intrathecal phenol in the treatment of severe bilateral leg spasticity. Method. A retrospective case notes review of patients treated with intrathecal phenol by a rehabilitation service was performed. A simple rating scale based on comments in the case notes was used to identify changes in spasticity and treatment goals. Results. Forty patients were identified as having been treated with intrathecal phenol over a 10-year period. All patients had improvements in their spasticity, 34 of which were rated as substantial or excellent. All patients (in whom the effect was documented), except one, had short-term improvement in the goals for treatment, 31 having substantial or excellent improvement. The effect was long lasting in many of the patients. Seven patients required repeat injections with similar outcomes. Seven patients experienced temporary side-effects. Conclusion. Intrathecal phenol is a useful alternative in treating selected patients with chronic severe bilateral leg spasticity that is unresponsive to other treatments.