New Insights on Havana Syndrome

On February 10th, 2022, the UT Southwestern Medical Center's Peter J. O’Donnell Jr. Brain Institute organized a day of conferences on the condition known widely as "Havana Syndrome," also called "Anomalous Health Incidents."

Dr. Kenneth Dekleva, a psychiatrist at UT Southwestern and former senior U.S. diplomat and regional Medical Officer Psychiatrist, had invited multidisciplinary speakers: ear, nose, and throat specialists; neurologists; psychiatrists; rehabilitation medicine specialists; a bioethics specialist; and an ambassador to Bulgaria, as well as a victim of Havana Syndrome.

An Example of Havana Syndrome

The Havana Syndrome victim, Marc P., who had a senior government position, traveled to Moscow in December of 2017 and stayed 10 days in a 5-star hotel in the center of Moscow, not far away from the U.S. Embassy.

In the middle of his second night at the hotel, Marc woke up with extreme vertigo, a splitting headache, and ringing in his ears. Marc reports that he never had any of those symptoms before. The vertigo lasted the whole night, got a little better in the next few days, then got worse again; Marc had to stay in his hotel room the last few days of his visit because of the intensity of the vertigo.

When Marc came back to the U.S., he reports that his symptoms got even worse—including brain fog, blinding headaches, vertigo, and loss of long-distance vision which prevented him from driving. Marc sought medical help but got very little, he says, because physicians did not take him seriously. To this day, Marc has headaches and only lately managed to get beneficial medical care at Walter Reed Hospital with some improvement.

Marc’s case is not unique.

We know more than 250 people (State Department and other American personnel) reporting similar symptoms to Marc’s. All these symptoms are considered part of Havana Syndrome/Anomalous Health Incidents.

The affected people were usually in their 20s, 30s, or 40s, in great physical shape, precleared, and prescreened. Their symptoms started when they were stationed in Cuba, Russia, China, India, Austria, Germany, Switzerland, or the U.S. They were staying at hotels, apartments, offices (other than embassies), and/or driving in an automobile when the symptoms first occurred.

Out of those more than 250 people, 24 of them showed puzzling combinations of symptoms never seen before. This includes a few people described who, associated with their feeling of dizziness and headache, reported hearing loud, high frequency, very directional sounds that seemed to come from a specific location. Both sounds and symptoms reportedly disappeared when victims left the room and reappeared when they reentered that same room.

Other Havana Syndrome victims described cognitive problems (memory problems and slow processing speed), nausea, hearing loss, ear pain, tinnitus, insomnia, irritability, and sometimes depression.

How Can Havana Syndrome Be Differentiated From Other Medical Conditions?

Asked for their opinion about how to differentiate Havana Syndrome from other medical conditions, the panel of specialists at the conference explained that the combinations of symptoms seen in Havana Syndrome could fit four categories of already known conditions:

• Persistent postural-perceptual dizziness (PPPD). People with PPPD complain of chronic dizziness and unsteadiness, but they usually have neither ringing in their ears nor headaches. The symptoms are frequently triggered by a viral infection or head trauma.
• Vestibular migraines. People with vestibular migraines have a history of migraine headaches and experience balance problems. However, people with vestibular migraines don’t have problems perceiving linear accelerations, both horizontally and vertically (sensed through the action of otolith organs in their inner ears). On the other hand, as professor of otolaryngology Dr. Walter Kutz explained, problems perceiving linear acceleration are characteristic of several people with Havana Syndrome.
• Traumatic brain injury (TBI). Patients with TBI have a history of one or several head traumas and radiological MRI findings are usually different than in Havana Syndrome patients.
• Other syndromes, such as functional neurological disorders. However, as with these other disorders and the three above conditions, symptoms of functional neurological disorders don’t disappear when sufferers leave a room and reappear when they reenter that same room.

The panel of multidisciplinary experts concluded that the combination of symptoms observed in Havana Syndrome is unique to the 21st century—thus, we need 21st-century explanations and solutions.

What Could Be a 21st-Century Explanation of Havana Syndrome?

According to the panel of experts, for the 24 most puzzling cases of Havana Syndrome, the most likely origin is directed radio frequency (RF) energy exposure to the brain.

One of the experts at the conference, Dr. Jeffrey Staab, chair of psychiatry and psychology at the Mayo Clinic and one of the 19 experts for the National Academy of Science on Havana Syndrome explained that "exposed to directed RF energy, the brain could suffer at a functional level without having any structural damage."

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The Challenge of Detecting the RF Source

Another one of the experts at the conference, Dr. James Giordano, professor of neurology and biochemistry at Georgetown University and Director of the Institute for Biodefense Research, noted that "if RF or EM energy is sent in repetitive nanosecond pulses, it could induce neuropathologic effects, and it would be very difficult to detect such pulses."

One puzzling element is that my own research shows that the limits of safe exposure to RF radiation are much lower in Russia and several other Eastern countries than they are in the U.S. It seems that Russia has done experiments showing that there is toxicity for the brain if exposed to low levels of RF energy (for example, 0.1 watts per square meter) for more than three hours. Comparatively, the limit of toxicity by U.S. standards is 10 watts per square meter (100 times more than in Russia).

What Should Be Done If Symptoms Similar to Havana Syndrome Occur?

At the end of the conference, I asked the panel of experts what someone should do if they experience a sudden onset of symptoms similar to those of Marc P’s. The answer I was given (paraphrased) was: Leave the affected zone immediately.

Another important tip that was given by the panel is to seek medical advice as soon as possible—because the sooner the problem is addressed and treated, the better chance we have of resolving it. The other reason to seek medical advice as soon as possible is to decrease the anxiety that comes with unfamiliar and sudden symptoms. As the panel of experts noted, the more anxious the person is, the more difficult it often is to treat the symptoms.

But one problem that Marc P. and other Havana Syndrome victims had is that four years ago, and until very recently, few officials or medical personnel took them seriously. Because the medical community generally didn’t understand the combination of symptoms, healthcare professionals tended not to address their complaints properly and in a timely manner, leaving the victims suffering for four years which further aggravated their anxiety.

Now—particularly at Walter Reed hospital in Washington, D.C.—care for Havana Syndrome victims is much more comprehensive. It's typically treated with a combination of selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants, cognitive behavioral therapy (CBT), physical exercise, physical therapy, proper nutrition, and proper sleep hygiene. Unfortunately, many other hospitals around the country are not yet familiar enough with Havana Syndrome to treat it or differentiate it from other diagnoses.

So, as Dr. Dekleva said when I interviewed him: “We need all academic medical centers in the U.S. to get involved and coordinate medical and basic science research to find the exact origin of Havana Syndrome, as well as treatments that work on a consistent basis.”