Chicago Block for PTSD

[drjohnson]

We recently had Twin A receive this experimental treatment. It was designed and has been used for some time on war veterans with PTSD. However, the doctor has begun trying to treat children with PTSD and symptoms similar to PTSD due to attachment disorders associated with adoption. In our case, our twins were very young when adopted and as far as we know were not physically abused, but as infants they were in an institutional setting in rural Russia. They were also likely to have been exposed to alcohol in the womb which can also yield attachment and PTSD symptoms.

The procedure itself is an anesthetic injection in the neck near certain spinal nerves associated with panic reactions. The percentage of people helped by this treatment seems to be related to age - that is the older the patient, the more likely to find relief. Twin A is only a few months shy of 18 so the likelihood of help was relatively high. Relief is supposed to be immediate upon waking from anesthesia.

For Twin A, we aren't sure if there was any benefit yet. We are hoping that lessening her panicked, reflexive reactions will allow her to benefit from her therapy and avoid her impulsive acting out. She is not very introspective and has trouble describing what she is feeling. She will say in the same conversation that she doesn't notice anything different, and then that she feels much better and less anxious. She is currently at boarding school, so we can't observe her directly. We're waiting for observations from the school.

So my post is not to recommend the procedure, but just to bring it to your attention as another possible avenue to explore with complicated kids. It's one of those things that on one hand sounds really weird, but on the other hand makes sense. There are no reported bad reactions or side effects so far. The doctor is named Lipov and is located in Hoffman Estates.

[eoffg]

Thanks for letting us know about this, as it is really interesting.
I was most interested to read that the anesthetic is injected into the 'stellate ganglia' at the C6 vertebra.
Where this ganglia is shared with C7 and T1.
The crucial issue, is that this ganglia and its 'nerve roots' are the origin of the type of 'primitive reflex' called the Moro or Startle Reflex.

Where recent research has shown that these 'primitive reflexes' don't originate from the brain. But rather originate from the spinal column.
Where each type of 'reflex', resides in a different vertebra.
Dr Lipov's research, could provide a deeper insight into primitive reflexes, and more importantly 'retained primitive reflexes'?
Where the 'retention' could actually be occurring in vertebra ganglia for a 'reflex'?

It is most interesting that the treatment simply involves injecting an anesthetic. Which is no doubt short lasting.
The ability to 'inhibit' each of these 'reflexes', follows a developmental timeline.
Though the ability to inhibit each reflex, involves the 'frontal cortex' taking control of each reflex, and developing the ability to inhibit.
But Trauma can disrupt developing the ability to inhibit a 'reflex'.
Where the 'reflex' is retained, and without control from the 'frontal cortex'.
So that it is locked on.
But I would speculate that what this brief anesthetic does?
Is that it provides a brief window of opportunity, for connections between the ganglia and the frontal cortex to be established?
So that the ability to inhibit the reflex develops.

Though this also raises a question about the potential to use this treatment with other spinal ganglia?
Of specific interest to me, is the Dorsal Root Ganglia, for the Sacral and Lumbar vertebra.
Where I am involved with some young children, that as result of brain injury. Have lost the ability to inhibit various foot, ankle, knee Reflexes.
So that they are barely able to walk.
But this treatment could potentially be used to address the spectrum of retained reflexes?

[drjohnson]

As I understand the length of efficacy can be permanent, although some people require a booster or two after periods of several months. I'm making stuff up here, but maybe it's like an inflammation? I really don't know why it doesn't wear off for many people. Twin A is enthusiastic enough to want more- but then, Twin A is Twin A. We talked to another mom whose much younger daughter tried the injection with great success,but after a few months it gradually wore off. She begged to go back for another round. That one was not as successful. Whether this was a function of her young age or something else, I don't know.

It does sound like it would have possibilities for other disorders as well. Why don't you e-mail Dr. Lipov and inquire? He's very friendly.

[healthy11]

I learn something new every day ~ thank you for mentioning this. I hope it does provide lasting relief.

[empeg1]

Trouble describing what she is feeling… alexithymia is a core symptom of FASD. I hope the therapist understands the cognitive limits with FASD as well as the issues with impulsivity, judgment, making connections between actions and consequences, etc. that are part of the brain damage. A major role of therapy with someone with FASD is to work with the individual to be able to accept help, absolutely critical to any success. And, to be supportive, to work with teaching skills for grounding, critical for working with an autonomic nervous system that is reactive, and to work on building a support network for the client. Insight work is not the deal. Cognitive Behavioral Therapy, CBT, is actually contraindicated with a client with FASD, unless important modifications are made or not to be used at all. It does not make sense to use cognition or top down processing as the process for therapy when the client's weakness neurologically is just that cognition. Some of the body oriented therapies developed for use with complex trauma make sense. And, there is ongoing research on the use of neurofeedback with good results so far, again to teaching better self-regulation and for decreasing anxiety. Be careful of meds. Folks with FASD are notorious for atypical reactions to psychotropic meds. And, the prevalence of seizures is much higher in FASD, so meds like Wellbutrin can be dicey. The advice is to start with very very small dosages and to go up in dosage in very very small steps as well to a avoid the use of multiple medications.

[eoffg]

That's good to know that he is very friendly, as I thought about contacting him.
Where after reviewing all of his published research, it appears that he hasn't considered his research in terms of 'Motor Issues'?
Which given that he has a Psychiatric background, is not surprising.

[empeg1]

Actually Dr. Libov is an anesthesiologist, not a psychiatrist, and is involved in pain management