Pulsed Radiofrequency-Enhanced Dual Sympathetic Block for the Treatment of Post-Traumatic Stress Disorder

Dual sympathetic blocks (DSBs) have been shown to provide significant symptom relief in individuals with post-traumatic stress disorder (PTSD). However, despite the clinical significance of DSB PTSD treatment, a subset patients experience recurrence somatic symptoms and trauma-induced anxiety. The purpose this case report is describe our successful treatment acute by using serial DSBs pulsed radiofrequency (PRF). An 18-year-old male who had suffered multiple childhood traumatic events presented severe persistent consistent diagnosis PTSD. patient previously treated myriad, multiple-year trials psychotropic medications psychotherapy as well lifestyle modifications involving art therapy physical exercise. Despite these psychiatric psychological interventions, his persisted. underwent total four bilateral DSBs, three which were enhanced PRF, over period 15 months at clinic, intervals three, four, six between appointments, respectively. At two-week follow-up after initial stellate ganglion block (SGB) procedure, major improvement patient's was observed, specifically anxiety heightened sense danger. These results confirmed reduction Checklist Version 5 (PCL-5) scores from 73 50. later, some returned. elected proceed PRF-enhanced DSB, he subsequently reported that general subsided 80%, PCL-5 50 42. This persisted for months, returned second DSB. patient’s score further dropped 42 22 an 80% symptoms, months. undergo third reducing demonstrated self-reported drop 20, has We highlight fact addition PRF selective blockade via injection reduced below diagnostic threshold. Furthermore, we efficacy may be additive successive procedures. also theoretical exposition findings.