Paradoxical motor and cognitive function recovery in response to zolpidem in a patient with hypoxic-ischemic brain injury: A case report
Myong Hun Hahm 1, Jungmin Woo 2*
1Department of Radiology, School of medicine, Kyungpook National University , 2Department of Psychiatry, School of Medicine, Kyungpook National University
Received: October 12, 2018; Accepted: November 27, 2018; Published online: November 27, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
We report an extremely rare case of a patient with hypoxic-ischemic brain injury who recovered consciousness and motor and cognitive functions due to paradoxical response after zolpidem administration. A 32-year-old woman who had attempted suicide by hanging was admitted. The patient had stabilized in a state of drowsy mentality, quadriparesis, dysphagia, and impaired cognition. Brain magnetic resonance imaging was suggestive of hypoxic ischemic brain injury and unilateral infarction in the right posterior cerebral artery territory. Due to sleep disturbance, zolpidem was administered, and paradoxically consciousness level and function returned to near-normal during the duration of the drug-effect. In addition to previous reports, our case characteristically showed remarkable motor and cognitive function recovery, not only consciousness level. The drug-effect time was gradually decreased after 18 months and absent after 3 years. We have reviewed related literature and discussed possible neuropharmacological and neurobiological mechanism.
Keywords: Zolpidem, ;Brain Hypoxia-Ischemia, Hanging, PCA infarction


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