A complex case presentation released today at the annual American Society of Anesthesiologists (ASA) meeting gave promising news to veterans suffering from post-traumatic stress disorder (PTSD) and memory dysfunction. The case reported by Eugene Lipov, M.D. encompassed further research on his study and use of a stellate ganglion block (SGB) ), the application of a commonly used pain management procedure where a local anesthetic is injected into a bundle of autonomic nerve fibers in the neck. This presentation is the first to focus on memory dysfunction associated with PTSD, a very common phenomenon.
Dr. Lipov pioneered the application of SGB for psychiatric applications in 2006. Called the “Chicago Block,” he and others following his work have seen marked success in treating PTSD and associated disorders with SGB. Dr. Lipov has published a number of articles on this subject, most recently in Journal of Affective Disorders, Military Medicine, Anesthesiology News and Medical Hypotheses.
The patient discussed in the report was a 41 year-old Navy veteran diagnosed with PTSD and poor memory function. He underwent neuropsychologic testing prior to receiving the Chicago Block for the purposes of obtaining baseline measure of PTSD symptoms and memory function. After his first SGB injection, the patient reported marked improvements in PTSD symptoms and an improvement in memory function. After a second SGB injection, performed 90 days after, the patient stated he perceived the improvements as more pronounced. Relative to his baseline and first SGB outcomes assessments, it was reported that the patient’s memory function had substantially improved more than 60 percent. In addition, prior to the first injection, the patient said he was non-employable. Following the first injection, the patient was able to secure a full-time position in the construction industry.
“My reasoning for the memory evaluation of this patient was based on a previous finding in another veteran three years prior,” said Dr. Lipov. “In that patient, I saw a remarkable improvement of both PTSD and memory, in addition to significant improvement in hypocampus (the part of the brain responsible for memory) function, demonstrated by functional MRI (see figure attached). I knew further study was needed.”
The prevalence of PTSD, a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma, affects up to 35 percent of this country’s 22.8 million combat veterans. Studies have found that as much as 60 percent of veterans with PTSD have concurrent memory dysfunction.
Working with Dr. Lipov on this case presentation was Dr. Peter Brown, Psy.D., D.A.A.P.M., a neuropsychologist specializing in diagnosis of PTSD and memory function evaluation. Dr. Brown is with Brownstone and Associates in Orland Park, Illinois.
Dr. Lipov is medical director of Advanced Pain Centers in Hoffman Estates and Oakbrook, Illinois and founder of Chicago Medical Innovations, a 501(c)(3), not-for-profit corporation focused on researching and implementing new methods to treat PTSD patients and hot flash sufferers. The findings of the study were presented as an abstract at the American Society of Anesthesiologists meeting on October 16, 2012, under the title “Stellate Ganglion Block Improved Refractory Post-Traumatic Stress disorder and Associated Memory Dysfunction: A Case Report and Systematic Literature Review.”