Brain Neurorehabil.  2018 Mar;11(1):e1. 10.12786/bn.2018.11.e1.

Upper Limb Pain and Paresthesia in a Post-Stroke Patient Treated with Ultrasound-Guided Electrical Twitch-Obtaining Intramuscular Stimulation (ETOIMS) of Scalene Muscles

• Nam JS
• Choe YR
• Yoon SY
• Yi TI

• KMID: 2408837
• DOI: http://doi.org/10.12786/bn.2018.11.e1

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.

Keyword

Stroke; Thoracic Outlet Syndrome

MeSH Terms

Adult
Basal Ganglia
Diagnosis
Extremities
Female
Humans
Muscles*
Paresthesia*
Physical Examination
Sensation
Stroke
Thoracic Outlet Syndrome
Upper Extremity*