[Very-high-dose droperidol and brain stem injuries]

Treating four comatose children with severe injuries of the brain stem, suffering from severe autonomic disorders without any indications for neurosurgery, we were led to increase gradually the doses of neuroleptics used as basis of treatment, the main one being Droperidol. The increase in dosage, often reaching very high doses, was rendered necessary owing to a phenomenon comparable to that of addiction, a steadily increasing dose was necessary each day to obtain the same beneficial effects of autonomic stabilization. A complete cure was obtained on each occasion, at the end of a coma varying between 20 days and two and a half months. The extreme case was the last case in which we were led to give in a single day, 7 grams of the drug to a 12 years old child, who completely recovered his motor and intellectual functions after a coma lasting thirty five days. Comparison of the four cases led us to suppose that the result is all the better when treatment with neuroleptics is started soon after the accident, in low dosage but regularly increased without fixing any other ceiling than the effect obtained, the toxicity of Droperidol seemed to us very low, even in very high dosage, provided the conditions of gradualness are respected. Although it is classical to say that the prognosis of trauma of the brain stem is more favourable in children than in adults, we are certain that such treatment contributed considerably to avoid a fatal issue or chronic invalidism.