Awakenings

Robin Williams & Oliver Sacks

AWAKENINGS

ABOUT AWAKENINGS

Dr. Malcolm Sayer, portrayed by Robin Williams in the movie Awakenings, was based on Dr. Oliver Sacks, a British neurologist, naturalist, historian of science, and writer (9 July 1933 – 30 August 2015) 

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Dr. Sacks's book Awakenings describes a series of extraordinary case reports explaining how patients trapped by Parkinsonism were re-awakened.

After the first world war, an epidemic of encephalitis lethargica started in Vienna and spread across the world. Many of those who survived developed a range of postencephalitic syndromes.

Dr. Sacks worked at Mount Carmel, an institution outside New York, which had 80 of these patients with post-encephalitic Parkinsonian syndrome. It affected all aspects of behaviour and trapped patients within themselves, often for decades. For patients such as Miriam H, who developed parkinsonism at the age of 12, levodopa was a miracle drug that released her from physical immobility at the age of 49.

His experiences led him to believe that the drug Levodopa (L-Dopa),  could be beneficial for other diseases as well, including this type of Parkinson's disease.

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Levodopa had dramatically different effects between patients and within the same patient. Despite being titrated slowly, the effects of levodopa were unpredictable and random.

Leonard L, when started on levodopa, returned to a happiness he “had not felt for thirty years.” Yet six weeks later he developed exaggerated sensitivity to the drug and even with tiny doses had uncontrollable side effects. Even when the drug was prescribed carefully, the complexity of the brain made taking it anything but straightforward, and for some patients it was a nightmare rather than a fairytale awakening.

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Sacks was awarded a CBE for services to medicine in the 2008 Birthday Honours. He once stated that the brain is the "most incredible thing in the universe". He became widely known for writing best-selling case histories about both his patients' and his own disorders and unusual experiences, with some of his books adapted for plays by major playwrights, feature films, animated short films, opera, dance, fine art, and musical works in the classical genre.

THE CURE

L-Dopa was administered to catatonic patients who survived the 1917–1928 epidemic of encephalitis lethargica, an atypical form of encephalitis, also known as "sleeping sickness" or "sleepy sickness”. Their awakening has led to L-DOPA being used to treat Parkinson's disease today.
 

THE CURE TODAY

L-DOPA crosses the protective blood-brain barrier, whereas dopamine itself cannot. Thus, L-DOPA is used to increase dopamine concentrations in the treatment of Parkinson's disease, Parkinsonism, dopamine-responsive dystonia and Parkinson-plus syndrome. The therapeutic efficacy is different for different kinds of symptoms. Bradykinesia and rigidity are the most responsive symptoms while tremors are less responsive to levodopa therapy.