Poster 291 Cumulative Toxicity of Oxaliplatin Resulting in Severe Sensory Polyneuropathy: A Case Report

Abstract

Disclosures: F. Chiou-Tan, Elsevier, Receipt of royalties Objective: Spasticity can cause torsion of the upper limb after injury to the brain from stroke or trauma. This may be treated with botulinum toxin, phenol, or alcohol injections. Existing anatomic references do not provide the location of muscle targets in this hemispastic position. This article reviews the anatomy of the proximal arm in the position of upper extremity hemispastic flexion synergy and its relationship to procedures in the clinical setting. Objective: To provide anatomically accurate schematics of proximal arm anatomy in the position of hemispastic flexion synergy relevant to needle procedures. Design: Musculoskeletal ultrasound images were obtained in a healthy subject in anatomic neutral and hemispastic position. Anatomic illustrations were derived from these images. Setting: Academic PMR Department. Participants: Healthy human subjects. Interventions: Musculoskeletal ultrasound images of the arm in the position of hemispastic flexion synergy as compared to anatomic neutral. Main Outcome Measures: not applicable Results or Clinical Course: Cross sectional schematics for the arm were drawn as they appear in imaging projections. The level of cross section was selected to highlight important anatomic landmarks for injection. Color coding was used to emphasize needle procedure targets (blue) and structures to be avoided (red). Change in position of key muscles commonly injected for upper extremity spasticity are illustrated. Conclusions: It is hoped the schematics created in this paper allow for safer and more accurate needle procedures in the arm for the treatment of spasticity.