Zolpidem in Neurorehabilitation of Minimally Conscious Patient – a Case Report

Česká verzia

Authors: K. Kotková ¹; Y. Angerová ¹; J. Kořenek ¹; K. Kupka ²; O. Švestková ¹
Authors place of work: Klinika rehabilitačního lékařství, LF UK a VFN v Praze ¹; Ústav nukleární medicíny, LF UK a VFN v Praze ²
Published in the journal: Cesk Slov Neurol N 2016; 79/112(3): 347-350
Category: Case Report

Summary

Neurorehabilitation also has to address the needs of patients in minimally conscious state (MCS). Zolpidem, a short acting non-benzodiazepine hypnotic, has been shown to induce paradoxical responses in some patients with MCS. We assessed zolpidem-induced changes using PET (pozitron emission tomography) in a patient with traumatic brain injury. The patient had PET at baseline and then 24 hours later after administration of zolpidem 10 mg, followed by a radioactive substance. After zolpidem, we observed significantly more intensive activity in the healthy temporal cortex of the right hemisphere. We attempted to utilize this transitory patient activity for training of new skills during a 3-month physiotherapy and occupational therapy programme. However, no development was seen. Similar experience has been described by several authors but they all advocate further research in the mechanism of action of zolpidem and appropriate diagnosis of MCS patients who might profit from its use.

Key words:
minimally conscious state – zolpidem – positron emission tomography – neurorehabilitation

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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