Extraordinary arousal from semi-comatose state on zolpidem - A case report

A young semi-comatose male patient was investigated using Tc-99m hexamethyl -propylene amine oxime (Tc-99m HMPAO) brain single photon emission computed tomography (SPECT) before and after administration of the gamma-aminobutyr ic acid (GABA) agonist zolpidem. It was observed that 15 minutes after appl ication of the drug the patient awoke from his semi-comatose condition and remained awake for the next 3 - 4 hours. When drug action subsided he retur ned to his semi-comatose state. Brain SPECT before drug application showed large hypo-active areas in certain parts of the brain. Brain SPECT after dr ug application showed a generalised cortical activation relative to the cer ebellum and a marked and amplified activation of the areas that were hypo-a ctive before drug application.