PT  - JOURNAL ARTICLE
AU  - Sophie Mirabell Lehnerer
AU  - Franziska Scheibe
AU  - Ralph Buchert
AU  - Stefan Kliesch
AU  - Andreas Meisel
TI  - Awakening with amantadine from a persistent vegetative state after subarachnoid haemorrhage
AID  - 10.1136/bcr-2017-220305
DP  - 2017 Jul 22
TA  - BMJ Case Reports
PG  - bcr-2017-220305
VI  - 2017
4099  - http://casereports.bmj.com/content/2017/bcr-2017-220305.short
4100  - http://casereports.bmj.com/content/2017/bcr-2017-220305.full
AB  - We report the case of a 36-year-old woman with a subarachnoid haemorrhage (SAH) caused by a rupture of a right-sided middle cerebral artery aneurysm and subsequent malignant infarction of the right hemisphere leading to a persistent vegetative state and severe spastic tetraparesis with recurrent myocloni. Nine months after disease onset, the patient was transferred to our department for diagnostic and therapeutic re-evaluation. The poor clinical condition could not be explained by the brain lesion caused by the SAH or infarction. Moreover, glucose metabolism was normal in brain regions not affected by SAH and infarction as shown by positron emission tomography with 18F-fluorodeoxyglucose. We terminated baclofen and reduced antiepileptics known to impair vigilance and cognitive functions. However, only after starting amantadine treatment we observed a stunning awakening of the patient fully orientated within days. Our findings warrant trials to investigate amantadine in the treatment of unresponsive wakefulness syndromes due to acute central nervous system diseases.