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Ultrasound-Guided Stellate Ganglion Block for Central Post-Stroke Pain: A Case Report and Review

Authors Liu Q, Zhong Q, Tang G, Ye L

Received 2 November 2019

Accepted for publication 20 February 2020

Published 26 February 2020 Volume 2020:13 Pages 461—464


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael A Überall

Qian Liu,1,* Qing Zhong,2,* Guoqiang Tang,1,* Ling Ye3

1Department of Anesthesiology, First People’s Hospital, Zigong, Sichuan, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital, Jianyang, Sichuan, People’s Republic of China; 3Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ling Ye
Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China

Background: Central post-stroke pain (CPSP) is refractory to pharmacotherapy (eg, NSAIDs, opioids, antidepressants, and anticonvulsants), and may require transcranial or deep brain stimulation.
Case Presentation: A 67-year-old woman presented with severe paroxysmal cramp-like pain on the right side, including the head and both upper and lower extremities. The pain started 5 years earlier, was initially mild and occasional, but gradually intensified to an unbearable degree with an average of 10– 15 daily episodes, each lasting for 5– 10 mins. The patient disclosed “hemorrhagic stroke” 10 years ago that resulted in hemiplegia on the right side. CT examination verified the lesion. The patient received daily injection of 2-mL 2% lidocaine under ultrasound guidance to block the stellate ganglion. Pain subsided rapidly in both intensity and frequency. On the seventh day, the patient no longer had pain episodes. At the last follow-up, 9 months later, the patient was free from pain.
Conclusion: Ultrasound-guided stellate ganglion block is a viable alternative for CPSP that is refractory to pharmacotherapy.

Keywords: central post-stroke pain, cramp-like pain, ultrasound, stroke, stellate ganglion block

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