RT Journal Article
SR Electronic
T1 Awakening with amantadine from a persistent vegetative state after subarachnoid haemorrhage
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-220305
DO 10.1136/bcr-2017-220305
VO 2017
A1 Lehnerer, Sophie Mirabell
A1 Scheibe, Franziska
A1 Buchert, Ralph
A1 Kliesch, Stefan
A1 Meisel, Andreas
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2017-220305.abstract
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.