neurolytic

Neurolytic refers to substances or procedures that destroy nerve tissue to interrupt nerve signaling. In medicine, neurolytic techniques aim to provide long-lasting relief from pain by chemically or physically disrupting targeted nerves. The term is commonly used for chemical neurolysis, in which agents are injected near specific nerve structures to achieve ablation.

Common chemical neurolytic agents include absolute alcohol and phenol solutions; glycerol is used in some protocols. The mechanism involves denaturation of proteins, disruption of myelin, and axonal degeneration, resulting in irreversible nerve damage and loss of sensation in the nerve’s distribution. Motor function may be affected if adjacent motor fibers are included in the treated area.

Indications are primarily cancer-related or refractory neuropathic pain when conventional therapies or nerve blocks are insufficient. Frequently targeted regions include the celiac plexus, superior hypogastric plexus, and splanchnic nerves for abdominal or pelvic pain, though neurolysis can be applied to other nerve regions in selected cases.

Procedure and outcomes: neurolytic treatment is performed by interventional pain specialists under imaging guidance, such as CT or fluoroscopy, with local anesthesia and sometimes conscious sedation. The neurolytic agent is injected around the targeted nerve or plexus to achieve diffusion and destruction. Pain relief varies; many patients experience significant relief lasting weeks to months, though some have partial or temporary effects, and some require repeat procedures.

Risks and considerations: potential complications include permanent sensory loss or dysesthesia, neuropathic pain, motor weakness if motor fibers are affected, hypotension, infection, and injury to adjacent structures. Contraindications include active infection, coagulopathy, or patient preference. Agent choice and technique depend on anatomy, prognosis, and clinical goals.