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February 1976

Cardiac Arrhythmias in Acute Central Nervous System Disease: Successful Management With Stellate Ganglion Block

Author Affiliations

From the Department of Medicine, State University of New York, Upstate Medical Center, Syracuse.

Arch Intern Med. 1976;136(2):203-207. doi:10.1001/archinte.1976.03630020057012

In 1954, the American literature carried the first description of a series of cases with electrocardiographic (ECG) abnormalities occurring with acute central nervous system (CNS) disease.1 Subsequently, a number of reports have described in detail the wave-form changes.2-8 Cardiac rhythm disturbances have also been noted in the experimental animal and in man, associated with acute CNS lesions. The role of the sympathetic nervous system in mediating these abnormalities was suggested by Korteweg9 and others10,11 on the basis of CNS stimulation studies. More recently, Yanowitz12 demonstrated similar changes with stimulation and sectioning of the cervical sympathetic nerve trunks. The similarity of ECG wave-form abnormalities associated with CNS disease and the prolonged QT interval syndromes was first noted by Moss.13 He reported a case of prolonged QTc, deafness, and syncope caused by recurrent ventricular tachycardia, which was successfully treated by left stellate ganglion block. This

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