Amantadine might prevent disturbed consciousness in dementia with Lewy bodies: A case report
2022 Volume 39 Issue 5 Pages 818-820
Details
2022 Volume 39 Issue 5 Pages 818-820
An 80–year–old man was admitted because of an attack of disturbance of consciousness (DOC). He had moderate difficulty in performing the activities of daily living and was carted off wheelchair–bounded for the past 4 years. On admission, he showed unresponsiveness with Japan Coma Scale Il score of 30. Caloric vestibular–ocular response was evoked with ice water, and his eyes were fully and conjugately deviated toward the irrigated ear. Electroencephalography (EEG) revealed diffuse 5Hz background activity. However, the cause of DOC was unknown.
His DOC lasted for about 7 hours after admission. When he became alert without treatment, he reported recurrent hallucinations of human faces for the past 5 years. In addition, neurological examination disclosed progressing dementia and marked parkinsonism with severe microphonia. EEG showed 7～8Hz activity.
Thus, a diagnosis of dementia with Lewy bodies (DLB) was made. However, he experienced two siinilar DOC attacks on day 6 after admission. The attacks lasted for a few hours and disappeared without treatment. Oral amantadine (AD）at a dose of 50mg/day was initiated on the 7th day after admission. The attack did not recur for next 4 months following AD administration; after that, the patient was lost to follow up. It is hypothesized that AD could inhibit nicotinic receptor function of DLB with DOC and may have prevented the recurrence of DOC. Further studies to determine the efficacy of AD are recommended.
