In times of the Corona Pandemic, where new evidence emerges that the Corona virus affects other organs including the brain, lets  revisit a case of an amazing awakening of people who had fallen into a frozen state for decades after contracting the sleeping sickness in the early 1900s.

Awoken by a kiss

In the fairytale, Snow-White, the king’s daughter, takes up a shared living arrangement with a bunch of dwarfs after a big row with her stepmom. When things have just started to look peachy in her new life, she makes the unwise decision to bite into a poisoned apple and falls into a state of deep sleep.

Her dwarfy roommates find her unresponsive, almost frozen and nothing they try can reanimate their lady pal. Instead they arrange a fancy glass coffin for her – a kind if slightly creepy gesture.

But then, a prince arrives, and he seems to have a special mojo going that the dwarfs lack, because he revives Snow-White with a single kiss.

So far, so Disney.

But what about real life?

Frozen

What if our own brain, the command center of our spaceship, the organ which turns us into the masters of our fates, our bodies, our minds, what if this decision hub stops functioning the way it is supposed to? What if it stops giving commands to the rest of the body, trapping the mind in a frozen shell like a prisoner in an isolation cell?  Is that how Snow White felt, while stuck in her glass coffin, dwarfs bustling about – present but unable to move, to communicate?

There are different conditions of the brain that can induce such a frozen state: catatonic schizophrenia, drugs such as MPTP and brain inflammation.

Awakening

The neurologist Oliver Sacks describes this true-life Snow-White story in his book Awakenings. In the late 1960s, Sacks  was physician to a group of patients who were in a permanently frozen state after a 1920 epidemic of Encephalitis Lethargica, a disease which was dubbed the “sleeping sickness” for putting its victims into a Snow-Whitesk sleep state.

Sacks treated the patients with massive doses of the then newly discovered L-DOPA, a drug that is a precursor to dopamine, and which still a mainstay treatment in Parkinson’s disease, where Dopamine is notoriously absent in specific brain regions. and some of them responded to the drug and returned back to life. In his book Sacks tells the moving story of those individuals who woke up with a 30-year gap in their lives – a story few fiction writers would dare to dream up because it seems too outrageous for anything but a fairy tale or a soap opera.

Happily ever after?

Alas, the story does not have a Disney style happy end and neither do most other L-Dopa stories.

The effects of the drug aren’t permanent and come at the cost of severe side effects.

Some of Sacks’ awakened patients fell back into their frozen state and others experienced severe side-effects and personality changes.

For most Parkinson’s patients the initial effects of L-Dopa wear off with time, and they start to experience so-called OFF periods, in which the drug effect is gone. There are a number of side-effects, the most notable being involuntary movements, so-called dyskinesia, but also hallucinations or cognitive impairments.

A tale without hope then?

I would disagree. Even if L-Dopa does not provide a happily ever after, even though it isn’t a true cure, a magic bullet, the drug still allows the afflicted patients a continuation or return to something resembling a normal life for much longer than would ever have been possible without the drug. 

Wanna read more on the topic?

I recommend Dr. Sacks’ book Awakenings (or if you’re not into books you could watch the 1990 movie with Robin Williams and Robert de Niro.

Another great book on the topic is Jon Palfreman’s Brainstorms, in which the author, a  journalist and Parkinson’s patient himself gives an overview of the disease background, history of Parkinson’s research and new treatment options.