Cervical Sympathetic Blockade in a Patient with Post-Traumatic Stress Disorder: A Case Report

Post Traumatic Stress Disorder (PTSD) as an Over Activation of Sympathetic Nervous System: An Alternative View

“…Those advantages are: significant clinical effectiveness that is rapid and patient compliance is close to 100% since it does not depend on the patient returning for multiple treatments or needing to take medications at home. Finally, SGB seems to have significant effect on a suicidal patients as noted by [20,22].…”

“…The first documented use of SGB for psychiatric effect was its use in the resolution of depression by bilateral SGB as noted by clinicians at the Cleveland Clinic in 1947 [19]. The first case study of successful use of the SGB to treat PTSD was reported by the author in 2008 [20]. Since 2008 a number of other institutions have utilized SGB for treatment of PTSD.…”

“…Clinical results have been very encouraging. The institutions were: Walter Reed National Medical Center (Mulvaney 2010), Naval Medical Center San Diego [21], Tripler Army Medical Center [22], and Advanced Pain Centers [20,23,24]. Preliminary effectiveness rate seems to be 60 to 75 % [24].…”

Modulation of NGF by cortisol and the Stellate Ganglion Block – Is this the missing link between memory consolidation and PTSD?

“…Park et al was among the first to report successful treatment of PTSD by a cervical sympathetic block in an animal model in 1997 [20]. In 2008, Lipov et al documented reduction of PTSD symptoms following a Stellate Ganglion Block (SGB), an injection of local anesthetic next to the Stellate Ganglion [21]. The working hypothesis was that the autonomic nervous system modulates PTSD via a complex neurological pathway beginning with NGF and culminating in excess concentration of norepinephrine.…”

A possible mechanism for PTSD symptoms in patients with traumatic brain injury: central autonomic network disruption

“…Norepinephrine levels in cerebrospinal fluid have been correlated with the severity of PTSD symptoms in patients with PTSD (Geracioti et al, 2001). Lipov et al (2008) demonstrated and later reviewed (Lipov and Kelzenberg, 2012) successful use of stellate ganglia block to treat PTSD symptoms. A stellate ganglia block prevents lateralized sympathetic nervous system input from the stellate ganglia to the periphery and there is some evidence that is may also affect intracranial activity.…”