Zolpidem improves akinesia, dystonia and dyskinesia in advanced Parkinson's disease.

摘要

Zolpidem, an imidazopyridine hypnotic drug acting as a selective gamma-aminobutyric acid (GABA) type A agonist, has been reported to produce significant motor improvement in patients with Parkinson's disease (PD).1 However, relevant reports are scarce. We report a patient with advanced PD who had had a unilateral pallidotomy, unilateral thalamotomy and bilateral deep brain stimulation (DBS) of the subthalamic nuclei, who demonstrated an immediate improvement in akinesia, dystonia and dyskinesia after 10 mg Zolpidem.A 53-year-old man was diagnosed with PD at the age of 30 years. The initial presentation was with left hemi-parkinsonism, characterized by rest tremor, bradykinesia and rigidity. He had undergone right pallidotomy in 1985 (without improvement), right thalamotomy in 1985, and bilateral deep brain stimulation (DBS) in 2001. In 2005, after adjustment of his medication and reprogramming of the DBS, he remained severely disabled (Hoehn and Yahr stage V). In addition, he also developed episodic and unpredictable dyskinesia and mild dystonia. Ten months later, he experienced an episode of severe dystonia which presented as sustained mouth-opening and head-turning to the right side. He could barely move. We administered 10 mg Zolpidem at night for his insomnia.