Hypothetical Inventions, Ch.2

Maximizing Stimulation of the Medial Brachial Cutaneous Nerve in Tickleectomy:  An Anatomical Study


Objective:  With more and more patients dealing with fatigue, sleep problems, headaches, depression, anxiety, and fibromyalgia there has been an increased demand for skilled practitioners to develop standardized techniques for maximizing stimulation of the medial brachial nerve in tickleectomy.  Knuthead and Debag describe efficacy of the tickleectomy at the Mayo Clinic and report nearly a 85% success rate with the full tickleectomy protocol applied.  Unfortunately, up to now, the medical community has failed to consistenty provide standardized treatment regimes for practitioners of the tickleectomy to duplicate the successes of the Knuthead study.

Methods:  It is imperative that the victim remain restrained during the tickleectomy procedure.  In this study, the victims's arms were placed palm up on padded arm boards, slightly abducted approximately 60 degrees from the main axis of her body. Both arms were secured to arm boards by means of two-inch "hook and loop" straps (similar to VELCRO^®) affixed loosely over the  victims's forearms.  If the victim is able to move during the procedure, the efficacy of the procedure diminishes exponentially with the coefficient of movement permitted.

Next, the skilled practitioner must identify and isolate the medial brachial nerve for maximum effect.   This anatomical feature is nomally located at about 7 cm proximal to the medial epicondyle, and there is an arborization of 2 to 3 cutaneous branches at that point which can also be stimulated.  However, the nerve sends 3 to 4 branches through the muscular fascia across the ulnar nerve to skin of the medial arm at about 15 cm proximal to the medial epicondyle which should also prove fertile ground for the application of the tickle protocol.


Conclusions: Gargalesis was demonstrated by repeated application to high pressure sensitive areas.  Hypergargalesthesia  was reported in all cases, even those in the placebo control group.   These results confirm that further study and repeated application of tickle protocols must be applied to achieve the desired treatment outcomes.