to the editor: There is currently no effective pharmacologic treatment for spinocerebellar ataxia. We describe a family of five patients, four of whom had clinical improvement within one hour after the ingestion of zolpidem (10 mg). The diagnosis of spinocerebellar ataxia type 2 was confirmed by molecular analysis. Analysis of DNA for CAG repeat expansions in the SCA1 , 2 , 3 , 6 , and 7 genes revealed expansion of CAG repeats at the SCA2 locus.Patient 1, a 49-year-old man with titubation, dizziness, and loss of balance from the age of 34 years, had deteriorating speech and handwriting. Cerebellar signs included moderate gait ataxia, intention tremor, and dysdiadochokinesis, as well as titubation. Deep-tendon reflexes were all brisk. After treatment with zolpidem, ataxia, intention tremor, and titubation improved moderately. Pollock Park Family Practice Springs 0084, South Africa 1. Salva P, Costa J. Clinical pharmacokinetics and pharmacodynamics of zolpidem: therapeutic implications. Clin Pharmacokinet 1995;29:142-53. 2. Thomas P, Rascle C, Mastain B, Maron M, Vaiva G. Test for catatonia with zolpidem. Lancet 1997;349:702. 3. Clauss RP, Güldenpfennig WM, Nel HW, Sathekge MM, Venkannagari RR. Extraordinary arousal from the semi-comatose state on zolpidem: a case report. S Afr Med J 2000;90:68-72. 4. Cohen L, Chaaban B, Habert M-O. Transient improvement of aphasia with zolpidem. N Engl J Med 2004;350:949-50.
5.Clauss RP, Nel HW. The effect of zolpidem on brain injury and diaschisis as detected by 99mTc HMPAO brain SPECT in humans. Arzneimittelforschung (in press).
Correspondence