Effectiveness of combined use of levodopa and amantadine on prolonged consciousness disturbance due to traumatic brain injury in children—A case report

Abstract

Prolonged consciousness disturbance associated with traumatic brain injury (TBI) in children is one of the most serious complications for rehabilitation in order to perform cognitive/behavioral therapy. We report two cases of young TBI who got the remarkable recover by combined use of Levodopa and Amantadine. Case: TBI in two children. Case 1 was a 17-year-old man with diffuse brain injury following traffic accident showing prolonged consciousness disturbance and easy irritability due to damage of bilateral orbital part of inferior frontal gyrus. Case 2 exhibited similar symptoms at 14 years of age. After admission to our recovery rehabilitation ward, they had daily 6 hours of rehabilitation, and at the same time, and took Levodopa and Amantadine for 10 weeks. In case 1, the disorder of consciousness was changed from E1V2M4 to E4V5M6 Glasgow Coma Scale, WAIS - III also to VIQ 72 → 96, PIQ 48 → 80, FIQ 58 → 87, FIM improved from 40 to 93, he discharged to his home in 3 months after hospitalization, and then returned to high school. In addition, he succeeded in getting a driver's license. Case 2 also followed a similar course and succeeded in successful recovery. It is said that deficiency of dopamine, a mediator in the brain, is involved in prolonged consciousness disturbance and easy irritability after TBI of children. It is thought that Levodopa was converted into dopamine in the brain, and Amantadine was activated dopamine in the brain by enhancing the neurotransmission of dopamine in the brain. It suggests that this therapy will be recommended as one of treatment methods for TBI in children.