[Valve of symptomatic therapy with memantine in cerebral coma. II. Development of stretch synergisms in coma with brain stem symptoms]

1,3-Dimethyl-5-aminoadamantane (DMAA, D-145, memantine, Memantine) was used in a group of 25 patients of both sexes in coma and with brain stem symptoms for symptomatic therapy. Only adults in whom a severe obtuse craniocerebral trauma was present were included in the study. The mean treatment time was 9.5 days, and the mean observation period 25 days. The clinical courses were established in accordance with Frowein's classification of coma. As expected, coma forms 3-4 exhibited only insubstantial changes during the observation period. About 30% of the coma-3 patients underwent a development to the apallic syndrome. Contrary to our expectations, a development to coma 1 took place in just under half of the coma-3 patients under memantine therapy during the observation period. The efficacy of the memantine treatment was also checked electromyographically. Both a marked reduction of the spontaneous rhythmic discharges and a reduction of the stimulus-dependent stretch movements were found in the superficial EMG of quadriceps muscle. In the transition stages of coma 3-4 the effects of the aminoadamantane therapy were demonstrable only in the EMG. The results are interpreted in the sense of a suppressing action of the substance on the gamma system of positional and posture motor activity.