# Epipharyngeal Abrasive Therapy (EAT) Improved Premature Ventricular Contractions (PVCs) and Brain Fog Associated With Long COVID: A Case Report

## TL;DR

A 50-year-old man with Long COVID symptoms saw improvement in heart irregularities and brain fog after using a non-drug therapy called Epipharyngeal Abrasive Therapy (EAT).

## Contribution

This case report introduces EAT as a potential non-pharmacological treatment for autonomic symptoms in Long COVID.

## Key findings

- EAT led to a marked reduction in PVC burden as shown by Holter electrocardiography.
- Improvement in brain fog and work motivation occurred later after EAT initiation.
- EAT may have time-dependent effects on peripheral and central autonomic regulation in Long COVID.

## Abstract

A 50-year-old man with premature ventricular contractions (PVCs) detected before coronavirus disease 2019 (COVID-19) infection developed persistent fatigue and brain fog following COVID-19, which caused difficulty in continuing his work. Epipharyngeal abrasive therapy (EAT) was started without pharmacological treatment. Serial Holter electrocardiography demonstrated a marked reduction in PVC burden after continued EAT. In contrast, improvement in brain fog and recovery of work motivation occurred at a later stage, eventually allowing him to return to work. PVCs are considered an autonomic-sensitive peripheral manifestation, whereas brain fog likely represents dysfunction of central autonomic networks. The temporal dissociation observed between early improvement in PVCs and delayed cognitive recovery indicates that EAT may exert time-dependent effects on peripheral and central autonomic regulation. This case suggests that EAT could serve as a non-pharmacological and minimally invasive therapeutic option for both peripheral and central symptoms associated with autonomic dysfunction in Long COVID.