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

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. 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. 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. 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.