Upper Limb Pain and Paresthesia in a Post-Stroke Patient Treated with Ultrasound-Guided Electrical Twitch-Obtaining Intramuscular Stimulation (ETOIMS) of Scalene Muscles.
- Author:
Je Shik NAM
1
;
Yeo Reum CHOE
;
Seo Yeon YOON
;
Tae Im YI
Author Information
- Publication Type:Case Report
- Keywords: Stroke; Thoracic Outlet Syndrome
- MeSH: Adult; Basal Ganglia; Diagnosis; Extremities; Female; Humans; Muscles*; Paresthesia*; Physical Examination; Sensation; Stroke; Thoracic Outlet Syndrome; Upper Extremity*
- From:Brain & Neurorehabilitation 2018;11(1):e1-
- CountryRepublic of Korea
- Language:English
- Abstract: In post-stroke patients, the pain or paresthesia of the affected limb is common. These symptoms may be caused by a variety of pathologic conditions. Considering the debilitating effects of the pain, it is important to determine the exact cause and manage appropriately. A 41-year-old woman who had experienced a hemorrhagic lesion in the right basal ganglia and corona radiata 4 months previously presented with an irritating tingling sensation in her left upper extremity. She failed to respond to a number of treatment options including medications and physical agent modalities. Following a diagnosis of disputed thoracic outlet syndrome (TOS) caused by scalene muscle dysfunctions, she received ultrasound-guided electrical twitch-obtaining intramuscular stimulation (ETOIMS) which significantly alleviated the pain. This case suggests that the disputed TOS should be considered as one of the possible causes of post-stroke pain, and that detailed history-taking and physical examination, as well as imaging or electrophysiological studies, might be required for accurate diagnosis. Furthermore, ultrasound-guided ETOIMS can be used as a safe and minimally invasive technique for the treatment of the disputed TOS with fewer systemic and local side effects.
