Lipov Eugene G, Navaie Maryam, Brown Peter R, Hickey Anita H, Stedje-Larsen Eric T, McLay Robert N
Advanced Pain Centers, S.C., 2260 West Higgins Road, Suite 101, Hoffman Estates, IL 60169, USA.
Mil Med. 2013 Feb;178(2):e260-4. doi: 10.7205/MILMED-D-12-00290.
The prevalence of post-traumatic stress disorder (PTSD) has reached epidemic proportions among U.S. veterans, many of whom also have concurrent alcohol use disorder. This case report describes improvements in PTSD symptom severity and memory dysfunction in a combat-exposed veteran with persistent PTSD and alcohol use disorder following two treatments of stellate ganglion block (SGB). PTSD severity was measured using the PTSD Checklist, Military Version. Memory function was evaluated using the Rey Auditory Verbal Learning Test. One month after the first SGB, a 43.6% reduction in PTSD severity was observed along with increases in immediate memory (50%), recent memory (28%), and recognition memory (25%). Following a second SGB, PTSD severity decreased by 57.7% and memory function substantially improved, with pronounced changes in immediate memory (50%), recent memory (58%), and recognition memory (36%). One year after SGB treatments, the patient has stopped drinking alcohol, continues to have sustained relief from PTSD, has improved memory function, and has become gainfully employed. Future studies that employ robust epidemiologic methodologies are needed to generate confirmatory evidence that would substantiate SGB's clinical utility as an adjunctive treatment option for PTSD.
创伤后应激障碍(PTSD)在美国退伍军人中已达到流行程度,其中许多人还同时患有酒精使用障碍。本病例报告描述了一名患有持续性PTSD和酒精使用障碍的参战退伍军人在接受两次星状神经节阻滞(SGB)治疗后,PTSD症状严重程度和记忆功能障碍得到改善。使用军事版PTSD检查表测量PTSD严重程度。使用雷伊听觉词语学习测验评估记忆功能。第一次SGB治疗后一个月,观察到PTSD严重程度降低了43.6%,同时即刻记忆(提高了50%)、近期记忆(提高了28%)和识别记忆(提高了25%)均有所增加。第二次SGB治疗后,PTSD严重程度降低了57.7%,记忆功能大幅改善,即刻记忆(提高了50%)、近期记忆(提高了58%)和识别记忆(提高了36%)均有显著变化。SGB治疗一年后,患者已戒酒,PTSD持续缓解,记忆功能改善,并已找到有收益的工作。需要采用强大流行病学方法的未来研究来产生确证性证据,以证实SGB作为PTSD辅助治疗选择的临床效用。