{"title":"星状神经节阻滞治疗难治性周期性肢体运动障碍1例。","authors":"Aaron Burshtein, Vineet Aggarwal, Jung H Kim","doi":"10.1007/s00415-025-13054-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Periodic limb movement disorder (PLMD) involves periodic, stereotypic movements of upper/lower extremities during sleep. Propriospinal myoclonus (PSM) involves repetitive, irregular, myoclonic jerks starting in the midthoracic region and propagating to adjacent segments through propriospinal pathways. Limited evidence exists for interventional modalities. This report discusses the utility of stellate ganglion block (SBG) for PLMD.</p><p><strong>Methods: </strong>A review of one patient record who underwent SGB for PLMD.</p><p><strong>Results: </strong>We present a case of successful treatment of refractory PLMD with SGB.</p><p><strong>Discussion: </strong>This case demonstrates complicated PLMD that was refractory to numerous treatment modalities. However, SGB was shown to significantly improve the patient's painful nocturnal spasms. The hallmark of PLMD is myoclonic movement of upper and lower extremity thought to be due to hyperactivity of propriospinal neurons. The stellate ganglion is thought to be the source of a sympathetic nervous system activation and blocking the ganglion with local anesthetic reduces sympathetic activity. SGB for PLMD has not been previously described. However, our results indicate that communication between motor neurons and sympathetic nervous system is possible due to the plasticity of propriospinal interneurons. While the indication for SBG is rapidly expanding, its application for PLMD is truly novel. Further research is desperately needed to establish SGB as a solid treatment modality for PLMD.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"335"},"PeriodicalIF":4.8000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Stellate ganglion block for refractory periodic limb movement disorder: case report.\",\"authors\":\"Aaron Burshtein, Vineet Aggarwal, Jung H Kim\",\"doi\":\"10.1007/s00415-025-13054-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Periodic limb movement disorder (PLMD) involves periodic, stereotypic movements of upper/lower extremities during sleep. Propriospinal myoclonus (PSM) involves repetitive, irregular, myoclonic jerks starting in the midthoracic region and propagating to adjacent segments through propriospinal pathways. Limited evidence exists for interventional modalities. This report discusses the utility of stellate ganglion block (SBG) for PLMD.</p><p><strong>Methods: </strong>A review of one patient record who underwent SGB for PLMD.</p><p><strong>Results: </strong>We present a case of successful treatment of refractory PLMD with SGB.</p><p><strong>Discussion: </strong>This case demonstrates complicated PLMD that was refractory to numerous treatment modalities. However, SGB was shown to significantly improve the patient's painful nocturnal spasms. The hallmark of PLMD is myoclonic movement of upper and lower extremity thought to be due to hyperactivity of propriospinal neurons. The stellate ganglion is thought to be the source of a sympathetic nervous system activation and blocking the ganglion with local anesthetic reduces sympathetic activity. SGB for PLMD has not been previously described. However, our results indicate that communication between motor neurons and sympathetic nervous system is possible due to the plasticity of propriospinal interneurons. While the indication for SBG is rapidly expanding, its application for PLMD is truly novel. Further research is desperately needed to establish SGB as a solid treatment modality for PLMD.</p>\",\"PeriodicalId\":16558,\"journal\":{\"name\":\"Journal of Neurology\",\"volume\":\"272 5\",\"pages\":\"335\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-04-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00415-025-13054-8\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00415-025-13054-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Stellate ganglion block for refractory periodic limb movement disorder: case report.
Objectives: Periodic limb movement disorder (PLMD) involves periodic, stereotypic movements of upper/lower extremities during sleep. Propriospinal myoclonus (PSM) involves repetitive, irregular, myoclonic jerks starting in the midthoracic region and propagating to adjacent segments through propriospinal pathways. Limited evidence exists for interventional modalities. This report discusses the utility of stellate ganglion block (SBG) for PLMD.
Methods: A review of one patient record who underwent SGB for PLMD.
Results: We present a case of successful treatment of refractory PLMD with SGB.
Discussion: This case demonstrates complicated PLMD that was refractory to numerous treatment modalities. However, SGB was shown to significantly improve the patient's painful nocturnal spasms. The hallmark of PLMD is myoclonic movement of upper and lower extremity thought to be due to hyperactivity of propriospinal neurons. The stellate ganglion is thought to be the source of a sympathetic nervous system activation and blocking the ganglion with local anesthetic reduces sympathetic activity. SGB for PLMD has not been previously described. However, our results indicate that communication between motor neurons and sympathetic nervous system is possible due to the plasticity of propriospinal interneurons. While the indication for SBG is rapidly expanding, its application for PLMD is truly novel. Further research is desperately needed to establish SGB as a solid treatment modality for PLMD.
期刊介绍:
The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field.
In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials.
Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.