The use of amantadine in patients with unresponsive wakefulness syndrome after severe cerebral hemorrhage

ABSTRACT

Background

Amantadine is currently recommended for use in patients of post-traumatic brain injury with unresponsive wakefulness syndrome (UWS). However, the application of amantadine in UWS after cerebral hemorrhage has only been rarely reported. This allows for a further exploration of the role of amantadine in the treatment of UWS resulting from a severe cerebral hemorrhage.

Methods

We observed the changes of seven patients with UWS of intracerebral hemorrhage after taking amantadine. We also carried out a detailed neurological examination of the patient with disorders of consciousness to include or exclude subjects for the study. CRS-R score was used to evaluate the neurological recovery.

Results

An improvement in consciousness was observed within 3–6 days after the start of amantadine administration in all seven cases (n = 7/7; 100%). Five patients recovered conscious and left aphasia, hemiplegia and other sequelae, and two patients recovered from UWS to minimally conscious state (MCS).

Conclusions

In this study, amantadine administration showed substantial positive effects on recovery following severe cerebral hemorrhage. We recommend further randomized controlled studies to determine the efficacy of amantadine.

KEYWORDS:

• Amantadine
• unresponsive wakefulness syndrome
• cerebral hemorrhage

List of abbreviations

UWS: Unresponsive Wakefulness Syndrome; PVS: persistent vegetative state; MSTF: Multisociety Task Force; MCS: minimum consciousness state.

Authors’ contributions

YG and JY contributed to the conception and design, acquisition of data, analysis and interpretation of data and were involved in drafting the manuscript and revising it critically for important intellectual content. LLM, LF, YZ, LY and XHL contributed to the acquisition of data, analysis and interpretation of data. All authors have given final approval of the version to be published. Each author agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Ethics approval and consent to participate

This study was approved by the Ethics Committees of Beijing Chao-Yang Hospital of Capital Medical University.

Consent for publication

Written informed consents were obtained from the patient and her parents for publication of this Case Report and any accompanying images. Copies of the written consent are available for review by the Editor of this journal.

Competing interests

The authors declare that they have no competing interests.

Availability of data and materials

A minimum data set may be made available from the corresponding author following reasonable request.