Walter Reed Army Medical Center in Bethesda, MD, has published case reports detailing the successful treatment of combat-related post-traumatic stress disorder with a stellate ganglion block.
SGB is a 10-minute procedure during which local anesthesia is injected next to the stellate ganglion, a collection of nerves in the neck. SGB has been used safely to treat chronic pain and other ailments since 1925, but Dr. Eugene Lipov, a Chicago-area anesthesiologist and researcher, has pioneered this approach for the treatment of PTSD.
In duplicating Dr. Lipov's work, the Walter Reed team, led by Lieutenant Colonel Sean W. Mulvaney, M.D., found that, "unlike conventional treatments for PTSD, SGB appears to provide results almost immediately. Both patients experienced immediate, significant and durable relief."
One of the patients in the Reed case reports is a 36-year-old white male on active military duty whose symptoms began after the battle of Fallujah. The other patient is a 46-year-old Hispanic male retired from military service whose symptoms began 18 years ago in the first Gulf War. For over a year, both patients had been receiving pharmacologic treatment, which was ineffective in treating their symptoms; both suffered adverse effects from their medications, including depression, somnolence and erectile dysfunction.
The Walter Reed case reports, published in the May 2010 issue of Pain Practice 10.3, concluded that "selective blockade of the right stellate ganglion at C6 level is a safe and minimally invasive procedure which may provide durable relief from PTSD symptoms, allowing the safe discontinuation of psychiatric medications."
Dr. Lipov was invited to provide his expert opinion on the results in a guest editorial, which noted that Dr. Mulvaney's case reports were not the first to describe the psychiatric effects of the SGB. As he wrote, "[Other reports have] described the successful treatment of mental depression by bilateral stellate ganglion block, unexpected improvement in schizophrenia following SGB, and improvement of despair in rats by a superior cervical sympathetic ganglion block."
Dr. Lipov has published papers in several medical journals, providing a theoretical model of the biological brain changes that reverse PTSD following the procedure. "Using functional MRIs to show the part of the brain that is active during fear and other traumatic emotions, we can see and measure the physiologic changes that occur during trauma," he explains. "These MRIs are telling us that the cause of PTSD is physical in nature, and not simply a 'psychological condition.'"