Short-term amelioration of dysarthria after Zolpidem intake in a patient with primary familial brain calcification: a case report

Purpose: Transient improvement of aphasia, motor impairment, and disorders of consciousness after the use of zolpidem, a sedative, has been reported in several movement disorders and hyporesponsive syndromes. Here, we present a patient with Primary Familial Brain Calcification (PFBC), a rare neurodegenerative disease characterized by basal ganglia calcification, who experienced a transient improvement in speech following zolpidem administration. Methods: Serendipitously, a 40-year-old female with PFBC and severe dysarthria experienced transient amelioration of dysarthria after treatment with zolpidem, which was prescribed for insomnia. We carried out a comprehensive clinical assessment before and three hours after administration of zolpidem tartrate 10 mg, including standardized evaluations of speech, aphasia, motor function, and patient-perceived difficulties. Results: A transient improvement in speech was confirmed after zolpidem intake. However, notable side effects occurred, including worsening of fine motor control, coordination, postural stability, and bradykinesia. Conclusions: This case suggests that zolpidem can influence PFBC related neurological symptoms, identifying the facilitation of internal globus pallidus inhibition as a new therapeutic target. Its use in individual patients warrants the weighing of positive and negative clinical effects, patients’ personal preferences, and wearing-off which invariable occurs after repeated use.