L-DOPA treatment of comatose states due to cerebral lesions. Preliminary findings.

The results of a study on the effects of L-Dopa in brain-injured patients showing impairment of consciousness are reported. Fifteen patients were selected for this study. The degree of consciousness impairment, or level of coma, varied in the different patients. In all of them, however, the comatose state persisted unchanged for at least 6 days before the beginning of L-Dopa treatment. A gradual and progressive improvement of the level of consciousness, as well as of the EEG patterns, followed the administration of L-Dopa in patients whose treatment commenced while they were in comas III, II and I (classification of Fishgold and Mathis, 1959, and Rossi, 1962). On the other hand, the results of the treatment were questionable in the sequelae of coma (apallic syndrome, coma vigil, akinetic mutism). A direct relation between L-Dopa and consciousness improvement appears to be supported by: 1) the fact that the level of coma was stabilized for several days prior to L-Dopa treatment (see above); 2) the fact that consciousness improvement occurred abreast of L-Dopa dosage; 3) the observation in some patients that worsening followed the temporary withdrawal of L-Dopa treatment and, vice-versa, improvement followed its resumption. The hypothesis of neurochemical components in the processes responsible for the decrease of vigilance following cerebral injury would appear supported by the findings reported.