Treatment of High Voltage Electric Shock with Amantadine

High voltage electric shock injuries (HVESI) can lead to traumatic brain injury (TBI). Amantadin is a new drug that has been widely used for TBI. Twenty-six years old male patient developed loss of consciousness after 32.000 volt of electric shock and was admitted to the Intensive Care Unit with a Glasgow Coma Scale of 12. The patient had confusion-agitation and was complaining of blurred vision. Physical examination revealed isochoric pupils and bilateral positive light reflex. Fundus examination was normal. Cervical, thoracal and abdominal computed tomographic imagings were reported to be normal. However, cranial tomography revealed a subcutaneous hematom at the right occipital field. The inlet and outlet injury hole of of the electrical shock was localized at the palmar area and fingers at both hands. The burn injury was 2. and 3. degree with a percentage of 36 %. Fasciotomy was performed to the left foot under emergency conditions. Aggressive fluid resuscitation and alkaline diuresis was achieved with a maintenance of 1 ml/kg/hr urine output as creatine phosphokinase (CPK) level reached 933 IU/L and the urine tests revealed high density and myoglobinuria. ？ntravenous amantadine sulphate treatment was initiated on the first day with a dose of 2*1. On the third day of amantadine treatment, agitation had resolved and GCS was 15. On postoperative 6. day, the patient was transferred to the Plastic Surgery Department. As a result, amantadine treatment should be considered in every HVESI accompanied by TBI. Early initiation of the treatment provides neurological stability with a fast recovery of confusion, irritability and agitation