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金刚烷胺在重症脑出血后无反应性觉醒综合征患者中的应用。

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

机构信息

Department of Hyperbaric Oxygen Medicine, Beijing Chao-Yang Hospital, Capital Medical University , Beijing, China.

出版信息

Brain Inj. 2020 Jul 2;34(8):1084-1088. doi: 10.1080/02699052.2020.1780315. Epub 2020 Jun 18.

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.

摘要

背景

金刚烷胺目前被推荐用于创伤性脑损伤后无反应觉醒综合征(UWS)患者。然而,金刚烷胺在脑出血后 UWS 中的应用仅很少有报道。这使得我们可以进一步探讨金刚烷胺在治疗严重脑出血引起的 UWS 中的作用。

方法

我们观察了 7 例脑出血 UWS 患者服用金刚烷胺后的变化。我们还对意识障碍患者进行了详细的神经系统检查,以纳入或排除研究对象。使用 CRS-R 评分评估神经恢复情况。

结果

在开始使用金刚烷胺后 3-6 天内,所有 7 例患者(n=7/7;100%)均观察到意识改善。5 例患者恢复意识并遗留语言障碍、偏瘫等后遗症,2 例患者从 UWS 恢复到最小意识状态(MCS)。

结论

在本研究中,金刚烷胺治疗对严重脑出血后的恢复有显著的积极作用。我们建议进一步进行随机对照研究,以确定金刚烷胺的疗效。

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