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Evaluation

Skills Lab/Hands-On Demonstration Proposals

Session Name: Skills Labs

1808 - Ultrasound-guided extremity nerve blocks with alcohol and botulinum toxin injections in head and neck muscles for spasticity management

Saturday, November 18, 2023
9:00 AM – 12:00 PM CT
Location: CC R03
In-Person Ticketed

    Skills Lab Director(s)

  • YC

    Yuxi Chen, MD (she/her/hers)

    Attending
    Montefiore Med Center
    Bronx, New York

    No financial relationships to disclose.

    • Skills Lab Faculty(s)

  • Heakyung Kim, MD (she/her/hers)

    Professor and Chair, Dept of PM&R, Kimberly Clark Distinguished Chair in Mobility Research, UTSW
    University of Texas Southwestern Medical Center
    Dallas, Texas

    Disclosure(s): Abbvie Biotech: Consultant/Advisory Board (Terminated, December 31, 2021); Catalyst medical Education: Honorarium (Ongoing); Cleveland Clinic: Honorarium (Terminated, December 31, 2022); Ipsen: Research Grant (includes principal investigator, collaborator or consultant and pending grants as well as grants already received) (Ongoing); LIH Health Care: Honorarium (Ongoing); Merz: Consultant/Advisory Board (Terminated, April 30, 2022); Parcira Pharmaceutical Company: Consultant/Advisory Board (Ongoing)

  • Monika Desai, MD, FAAPMR, MD

    Division Chief and Program Director, Pediatric Rehabilitation Medicine
    Montefiore Medical Center/Albert Einstein College of Medicine
    Scarsdale, New York

    No financial relationships to disclose.

  • Jinpu Li, MD

    NA
    NA
    Washington, District of Columbia

    No financial relationships to disclose.

  • Mike Hagen, MD

    Fellow - Pediatric Rehabiltation
    Montefiore Medical Center
    Bronx, New York

    No financial relationships to disclose.

Lab Marketing

Description: Neurolysis of peripheral motor nerves can be performed to treat regional spasticity. A neurolytic agent such as alcohol (60-70% ethyl alcohol or 6-10% phenol) can be used to mobilize joints negatively affected by spasticity. Chemoneurolysis with Botulinum toxin injections to unusual spastic muscles can be done under ultrasound guide. This hand on session will teach alcohol neurolysis and diagnostic lidocaine nerve blocks for upper and lower extremity spasticity management as well as botulinum toxin injections to unusual spastic head/neck/hip muscles. Each presenter will give a short (5 minute) demonstration describing the technique of finding a nerve or unusual muscles and describing their utility. The attendees will divide into groups led by each presenter, to practice the technique on a live person. A hands-on training is vital for strengthening the clinical skills. This session will provide needed opportunity for in-depth training on spasticity management skills.

Botulinum toxin injections to spastic muscles of head/hip, such as pterygoid, psoas, temporalis or master muscles
Heakyung Kim, MD (15 min)
Overview of alcohol neurolysis and diagnostic lidocaine nerve blocks, Musculocutaneous nerve neurolysis
Monika Desai, MD (10 min)
Botulinum toxin injections to spastic muscles of neck
Jinpu Li, MD (5 min )
Nerve block to femoral nerve and sciatic motor branches to hamstrings
Yuxi Chen, MD (10 min)
Obturator nerve block
Michael Hagen, MD (5 min)
Nerve block to tibial motor branches to medial and lateral gastrocs
Yuxi Chen, MD (5 min)

There are 4 stations, 30 min / station

Learning Objectives:

  • Participants will learn to delineate the indications of 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
  • Participants will be able to demonstrate the Botulinum toxin injections to unusual spastic muscles of head/neck/paraspinals/hip, such as pterygoid, psoas, temporalis or master muscles