Kirkpatrick, Kennedy, Khan, Mashfee H, Deng, Yi et al. · Cureus · 2023 · DOI
This review article explores a procedure called stellate ganglion block (SGB), where doctors inject local anesthetic into nerve bundles in the neck to calm an overactive nervous system. The authors suggest that several conditions—including chronic fatigue syndrome, long-COVID, and loss of smell—may share a common problem: too much sympathetic nervous system activity (the 'fight or flight' response). Early case reports suggest SGB might help patients with these conditions when standard treatments don't work, though more research is needed.
ME/CFS is increasingly recognized as involving dysautonomia and sympathetic nervous system dysfunction; this review suggests a potential novel intervention targeting a putative underlying mechanism. If SGB proves effective in controlled trials, it could offer relief to ME/CFS patients with refractory symptoms who have exhausted conventional treatment options. Understanding sympathetic hyperactivity as a unifying pathophysiological feature across ME/CFS, long-COVID, and other conditions could improve diagnosis and treatment strategies.
This review does not establish that sympathetic hyperactivity is the primary cause of ME/CFS, nor does it prove that SGB is an effective treatment—only that preliminary case reports suggest potential benefit. The article lacks controlled trial data and does not demonstrate that NGF elevation is the mechanism by which SGB works. Correlation between sympathetic hyperactivity and symptoms does not establish causation.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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