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Autonomic dysfunction associated with locked-in syndrome in a child
J S Scott1, R R Ockey, G E Holmes
1Tulsa Developmental Pediatrics and Center of Family Psychology, Oklahoma, USA.
Summary
This report details a pediatric case of autonomic dysfunction and locked-in syndrome after hydrocephalus shunt revisions. Carbidopa/levodopa showed greater effectiveness than bromocriptine for treating these combined neurological conditions.
Area of Science:
- Neurology
- Pediatric Medicine
- Neuroscience
Background:
- Hydrocephalus management often involves shunt placement, which can lead to complications.
- Autonomic dysfunction and locked-in syndrome are rare but severe neurological conditions.
- Pediatric patients present unique challenges in managing complex neurological disorders.
Observation:
- A young boy presented with a rare combination of autonomic dysfunction and locked-in syndrome.
- The patient had undergone multiple shunt revisions for hydrocephalus.
- The clinical presentation highlighted the complexity of co-occurring neurological deficits.
Findings:
- Literature review on autonomic dysfunction syndrome and its pediatric manifestations.
- Detailed clinical picture of the combined syndromes in a pediatric patient.
- Carbidopa/levodopa demonstrated significant efficacy in treating both autonomic dysfunction and locked-in syndrome.
- Bromocriptine was less effective compared to carbidopa/levodopa for the patient's conditions.
Implications:
- Highlights the potential for combined autonomic dysfunction and locked-in syndrome in pediatric hydrocephalus cases.
- Suggests carbidopa/levodopa as a potential therapeutic option for this complex presentation.
- Underscores the need for comprehensive management strategies for severe pediatric neurological conditions.