Clinical and electroencephalographic on–off effect of amantadine in chronic non-traumatic minimally conscious state
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Positive effect of amantadine in promoting clinical recovery in patients with disorder of consciousness (DOC) has been extensively evaluated in patients with prolonged post-traumatic vegetative state or minimally conscious state (MCS) [1, 2, 3, 4, 5], whereas few studies investigated amantadine effect in non-traumatic DOC [6, 7], and only one reported on a chronic post-anoxic MCS patient .
Here, we describe the on–off effect of amantadine in a 57-year-old woman who had acutely developed severe intracranial hypertension due to a colloid cyst of the third ventricle. Twelve months post-onset the patient met criteria for diagnosis of MCS plus [9, 10], as confirmed by repeated clinical evaluation using the Coma Recovery Scale-Revised (CRS-R) [11, 12]. Repeated conventional electroencephalography (EEG) recordings at rest  showed a predominant background theta activity (7 Hz), with occasional low-frequency posterior alpha activity (8 Hz).
Sixteen months post-onset, after...
KeywordsAmantadine Conscious State Minimally Conscious State Colloid Cyst Minimally Conscious State Patient
Conflicts of interest
The present research has not been sponsored by any commercial organization. The authors declare that they have no conflict of interest.
The study was approved by the local Ethics Committee, and performed according to the ethical standards laid down in the 1964 Helsinki Declaration and its later amendments.
Written informed consent was obtained from the legal guardian of patient.
- 3.Whyte J, Katz D, Long D, Di Pasquale MC, Polansky M, Kalmar K, Giacino J, Childs N, Mercer W, Novak P, Maurer P, Eifert B (2005) Predictors of outcome in prolonged posttraumatic disorders of consciousness and assessment of medication effects: a multicenter study. Arch Phys Med Rehabil 86:453–462CrossRefPubMedGoogle Scholar
- 5.Giacino JT, Whyte J, Bagiella E, Kalmar K, Childs N, Khademi A, Eifert B, Long D, Katz DI, Cho S, Yablon SA, Luther M, Hammond FM, Nordenbo A, Novak P, Mercer W, Maurer-Karattup P, Sherer M (2012) Placebo-controlled trial of amantadine for severe traumatic brain injury. N Engl J Med 366:819–826. doi: 10.1056/NEJMoa1102609 CrossRefPubMedGoogle Scholar
- 12.Estraneo A, Moretta P, De Tanti A, Gatta G, Giacino J, Trojano L (2014) An Italian multicentre validation study of the Coma Recovery Scale-Revised. Eur J Phys Rehabil Med. (Epub ahead of print)Google Scholar
- 13.Forgacs PB, Conte MM, Fridman EA, Voss HU, Victor JD, Schiff ND (2014) Preservation of electroencephalographic organization in patients with impaired consciousness and imaging-based evidence of command-following. Ann Neurol 76:869–879. doi: 10.1002/ana.24283 PubMedCentralCrossRefPubMedGoogle Scholar