BACKGROUND

Patients with severe nontraumatic brain injuries often present with disorders of unconsciousness. Immediate neurologic care, neuroprotection, and early neurorehabilitation are core principles for better outcomes. Neurorehabilitation, through both pharmacological and non-pharmacological strategies, aims to enhance neuroplasticity for faster recovery. Amantadine, primarily known as an antiviral and used in Parkinson’s treatment, has shown a potential role for accelerating neuronal recovery and neurorehabilitation.

OBJECTIVE

Available literature on the use of amantadine for nontraumatic brain injury patients is limited. This scoping review aims to identify the potential benefits and limitations of amantadine in neurorehabilitation.

METHODOLOGY

In the literature review, the keywords "Amantadine" AND "Neurorehabilitation" were used to search PubMed, EBSCO, and the Cochrane Library for articles published between January 1, 2003, and August 2024. Inclusion criteria required that articles have clear research objectives, strict subject eligibility criteria, a detailed methodology, and the administration of amantadine for nontraumatic brain injuries. Out of 57 identified articles, only 7 were included in the study.

RESULTS AND DISCUSSION

Its benefits include improving the level of consciousness, accelerating recovery, decreasing mortality, managing delayed post-hypoxic encephalopathy, and improving verbal fluency in nonfluent speech. Its adverse effects and the paucity of available literature recommending amantadine for neurorehabilitation are the possible limitations.

CONCLUSION

Amantadine accelerates the neurologic recovery of patients with disorders of unconsciousness secondary to nontraumatic brain injuries.

RECOMMENDATION

Future studies may conduct meta-analyses, systematic reviews, and randomized controlled trials of amantadine in patients with nontraumatic brain injury to further strengthen its promising role in neurorehabilitation.

Human ; Amantadine ; Neurological Rehabilitation ; Neurorehabilitation

Cortical blindness, a consequence of bilateral occipital lobe lesions, typically manifests with partial or complete visual loss. It is often associated with the intriguing phenomenon of visual anosognosia, wherein patients paradoxically deny their profound visual loss, which would often lead to confabulation. This constellation of clinical findings points to Anton’s Syndrome. Bilateral occipital infarcts are the most common cause of cortical blindness, and the cooccurrence of visual anosognosia is frequently reported in these cases. We present a unique case of a 65-year-old right- handed Filipino male who experienced sudden, acute cortical blindness resulting from simultaneous bilateral occipital infarcts of likely cardioembolic origin secondary to atrial fibrillation. Despite the cortical blindness, the patient explicitly acknowledged his blindness and was not demonstrating signs of denial or confabulation. The patient’s neurological examination was otherwise notable only for the visual impairment, without other focal deficits. This clinical presentation stands in contrast to the typical features of Anton's syndrome. Cranial magnetic resonance imaging revealed acute infarcts in both occipital lobes and the right pons. This unusual presentation underscores the heterogeneity in the clinical expression of posterior circulation strokes. This case contributes valuable insights into the complex neural pathways involved between visual information processing, its awareness, and speech production following bilateral occipital infarction. This is the Philippines’ unprecedented case of bilateral visual loss after simultaneous acute bilateral occipital infarcts occurring without accompanying visual anosognosia.

Human ; Male ; Aged: 65-79 Yrs Old ; Cardioembolic Stroke ; Embolic Stroke ; Stroke