title: Recovery in non-vascular locked-in syndrome during treatment with Sinemet.
abstract: A case of successful pharmacological therapy of non-vascular locked-in syndrome (LIS) is described. A 22-year-old male experienced aqueductal stenosis following an episode of viral meningitis 11 months prior to admission. A ventriculo-peritoneal shunt was inserted and subsequently revised three times. Following the last procedure, the patient remained mute, quadriplegic and aphagic. There was no change in the patient's status for 9 days. Bromocriptine (2.5 mg daily) was begun and increased to 45 mg daily without any change in PECS scores. It was then tapered and Sinemet (75/300 daily) was begun and increased to 75/750 daily. The PECS scores in all areas rose steadily during the subsequent 6 weeks. Sinemet may be of value in the rehabilitation therapy of non-vascular LIS; serial patient evaluation by a PECS system may facilitate assessment of the response.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Marianjoy Rehabilitation Center, Wheaton, IL 60187.
authors.forename: N
authors.initials: N
authors.lastname: Rao
authors.forename: J L
authors.initials: JL
authors.lastname: Costa
mesh_terms: D000203:Activities of Daily Living; D002230:Carbidopa / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004338:Drug Combinations / Q000008:administration & dosage; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D008587:Meningitis, Viral / Q000150:complications; D011782:Quadriplegia / Q000534:rehabilitation*
chemical_list: D004338:Drug Combinations; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa