O fenol como agente neurolítico no tratamento da espasticidade focal e multifocal

  • Dayrin Vanessa Tarazona Carvajal Faculdade de Medicina, Universidade de São Paulo – FMUSP
  • Natália de Oliveira Silva Faculdade de Medicina de Ribeirão Preto – FMRP-USP
  • Lucas Soiti Maeda Faculdade de Medicina de Ribeirão Preto – FMRP-USP
  • Marcelo Riberto Faculdade de Medicina de Ribeirão Preto – FMRP-USP https://orcid.org/0000-0001-9549-8830
Palavras-chave: Fenol, Espasticidade Muscular, Bloqueio Nervoso, Terapêutica

Resumo

A síndrome piramidal ocorre nas lesões do sistema nervoso central que afetam as vias corticoespinhais e são definidas pela tríade de fraqueza muscular, aumento dos reflexos miotáticos e espasticidade, que é definida pelo aumento involuntário da resistência ao movimento passivo cuja intensidade varia com a velocidade do movimento. Quando a espasticidade interfere na funcionalidade do paciente, dificultando o movimento ativo, causando dor ou dificultando a prestação de cuidados por terceiros, há necessidade de iniciar seu tratamento. Para o tratamento da espasticidade generalizada ou de grandes porções do corpo, a intervenção medicamentosa ocorre por via oral ou intratecal, conforme os recursos disponíveis, mas efeitos colaterais de intensidade variável e indesejáveis podem ocorrer, especialmente o comprometimento da atenção ou da consciência, que prejudicam o processo de reabilitação. O tratamento focal da espasticidade utiliza a toxina botulínica ou os bloqueios nervosos com fenol ou álcool. Este artigo revisa a literatura sobre as técnicas mais adequadas para realizar a neurólise com fenol. Os bloqueios neuromusculares com fenol são um tratamento efetivo, de ação imediata, baixo custo, duração prolongada e de poucos efeitos adversos quando são respeitados os cuidados regulares de aplicação.

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Publicado
2019-03-31
Seção
Tendências e Reflexões