LOUIS J. KARNOSH, M.D.
Department of Neuropsychiatry
W. JAMES GARDNER, M.D.
Department of Neurosurgery
The idea of attempting to alter cerebral function by interruption of the sympathetic nerves to the cerebral blood vessels is not a new one. As early as 1899 Alexander1 and in 1896 T. Jonnesco2 performed cervical sympathectomy in the treatment of epilepsy.
More recently Mixter and White, as reported by White and Smith-wick3 in 1941, carried out bilateral cervicothoracic sympathectomy in a series of patients with severe epileptic seizures but found that the final outcome was disappointing.
Dandy4 in 1931 reported his experience in the treatment of migraine by sympathectomy, as did Craig,5 and Love and Adson.6
Royle7 in 1932 described his experience in the treatment of a number of cerebral diseases by resection of the cervicothoracic sympathetic ganglia. However, Royle’s previous writings on the relief of spasticity by sympathetic ramisection had been so thoroughly discredited that this contribution attracted little attention.
In 1943 and again in 1946 Risteen8 and Volpitto9 reported favorably on the use of stellate ganglion block in cases of cerebral vascular occlusion and other neurologic disorders.
During the past year our interest in attempts to influence cerebral physiology by interrupting the cervical sympathetic nerves has been re-aroused. In January, 1946, a woman, aged 38, was observed with complete left hemiplegia of five weeks’ duration due to cerebral embolus. This patient had excruciating pain in the entire paralyzed side. There was such extreme dysesthesia of this side that the patient would scream when the skin was lightly touched. She presented a serious nursing problem because she would. . .