Affiliations: Physical Medicine and Rehabilitation Service, Jesse
Brown VA Medical Center, USA | Department of Physical Medicine and Rehabilitation,
Feinberg School of Medicine, Northwestern University, USA | Rehabilitation Institute of Chicago, Chicago, IL,
USA
Note: [] Corresponding author: Patrick J. Barrett, MD, Assistant Chief of
Physical Medicine and Rehabilitation Service, Jesse Brown VA Medical Center,
820 South Damen Avenue, Chicago, IL 60612, USA. Tel.: +1 312 569 6113; Fax: +1
312 569 8050; E-mail: [email protected]
Abstract: Objective: This report describes two pediatric patients undergoing
acute inpatient rehabilitation for acquired brain injury. Design: The first patient was a 16-year-old African American female
with an acquired brain injury from multiple intracranial hemorrhages secondary
to an arteriovenous malformation. The second patient was a 16 year-old African
American male who sustained a traumatic brain injury due to assault. In both
cases, the patients had difficulty participating in therapy due to significant
attention/arousal impairments. Results: Both patients demonstrated functional improvements after
the initiation of caffeine 80 mg daily. The first patient's function improved
from being unable to communicate to being able to signal yes/no with thumb
movements. The functional independence measurement (FIM) scores of the second
patient improved dramatically after caffeine was initiated. His function
improved from being totally dependent in ambulation, wheelchair ambulation, and
communication to only requiring moderate assistance with ambulation and
supervision with wheelchair ambulation and communication after 3 weeks of
treatment. The second patient's attention/arousal and FIM scores declined when
caffeine was stopped for 3 days and improved once administration of caffeine
resumed. There were no adverse events reported for either patient. Conclusion: Caffeine is a safe and inexpensive neurostimulant that
may be used to treat attention/arousal impairments. Additional research is
warranted to determine criteria of use, optimal timing, duration, and dosing of
caffeine administration and to investigate whether caffeine improves chronic
functional outcomes after ABI in pediatric acquired brain injury patients.
