Therapeutic Role of Amantadine in Prolonged Postictal Encephalopathy: A Case Report in an Elderly Patient.

IF 0.6 Q4 CLINICAL NEUROLOGY

Case Reports in Neurology Pub Date : 2025-08-20 eCollection Date: 2025-01-01 DOI:10.1159/000548013

Abdullah M Shadid, Rahaf S Alabbad, Sohaila Alshimemeri

{"title":"Therapeutic Role of Amantadine in Prolonged Postictal Encephalopathy: A Case Report in an Elderly Patient.","authors":"Abdullah M Shadid, Rahaf S Alabbad, Sohaila Alshimemeri","doi":"10.1159/000548013","DOIUrl":null,"url":null,"abstract":"Introduction: Prolonged postictal encephalopathy in elderly patients can be difficult to manage, especially when standard treatments fail. Amantadine, a dopaminergic agent with NMDA antagonist properties, is approved for use in Parkinson's disease and has demonstrated efficacy in enhancing recovery in TBI. However, its role in nontraumatic etiologies such as postictal states is not well established.Case presentation: We describe a 95-year-old man with multiple comorbidities who remained somnolent and minimally responsive for 14 days after convulsive status epilepticus, despite seizure control and metabolic correction. EEGs showed no epileptiform activity, and imaging revealed no acute pathology. A trial of amantadine 100 mg daily was initiated for suspected postictal encephalopathy. Within 48 h, the patient showed significant improvement in alertness, orientation, and interaction, returning near baseline by day 10.Conclusion: This case suggests a potential role for amantadine in treating prolonged postictal encephalopathy in elderly patients. Further research is needed to assess its efficacy in nontraumatic disorders of consciousness.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"17 1","pages":"113-118"},"PeriodicalIF":0.6000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503772/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000548013","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Prolonged postictal encephalopathy in elderly patients can be difficult to manage, especially when standard treatments fail. Amantadine, a dopaminergic agent with NMDA antagonist properties, is approved for use in Parkinson's disease and has demonstrated efficacy in enhancing recovery in TBI. However, its role in nontraumatic etiologies such as postictal states is not well established.

Case presentation: We describe a 95-year-old man with multiple comorbidities who remained somnolent and minimally responsive for 14 days after convulsive status epilepticus, despite seizure control and metabolic correction. EEGs showed no epileptiform activity, and imaging revealed no acute pathology. A trial of amantadine 100 mg daily was initiated for suspected postictal encephalopathy. Within 48 h, the patient showed significant improvement in alertness, orientation, and interaction, returning near baseline by day 10.

Conclusion: This case suggests a potential role for amantadine in treating prolonged postictal encephalopathy in elderly patients. Further research is needed to assess its efficacy in nontraumatic disorders of consciousness.

查看原文本刊更多论文

金刚烷胺在延长后脑病中的治疗作用：1例老年患者报告。

老年患者长期后脑病变难以控制，特别是当标准治疗失败时。金刚烷胺是一种具有NMDA拮抗剂特性的多巴胺能药物，已被批准用于帕金森病，并已证明在促进TBI恢复方面有效。然而，它在非创伤性病因中的作用，如后状态，还没有很好地确定。病例介绍：我们描述了一名95岁的男性，患有多种合并症，在惊厥癫痫持续状态后14天仍保持嗜睡和最低反应，尽管癫痫发作控制和代谢纠正。脑电图未见癫痫样活动，影像学未见急性病理。一项试验金刚烷胺100毫克每日开始怀疑脑病后。48小时内，患者在警觉性、定向和互动方面表现出显著改善，到第10天恢复到接近基线水平。结论：本病例提示金刚烷胺在治疗老年迟发性脑病中具有潜在的作用。需要进一步的研究来评估其对非创伤性意识障碍的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Case Reports in Neurology Medicine-Neurology (clinical)

CiteScore

1.50

自引率

0.00%

发文量

审稿时长

14 weeks

期刊介绍： This new peer-reviewed online-only journal publishes original case reports covering the entire spectrum of neurology. Clinicians and researchers are given a tool to disseminate their personal experience to a wider public as well as to review interesting cases encountered by colleagues all over the world. To complement the contributions supplementary material is welcomed. The reports are searchable according to the key words supplied by the authors; it will thus be possible to search across the entire growing collection of case reports with universally used terms, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.