Increased Arousal in a Patient with Anoxic Brain Injury After Administration of Zolpidem

Cohen, Suzanne L.; Duong, Thao

doi:10.1097/phm.0b013e318161971b

Cited by 55 publications

(51 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The conscious states in these subjects returned 2 to 4 hours after drug administration but improved again with zolpidem readministration. Similar transient effects have been reported in MCS due to anoxic brain injury [43][44]. However, in an assessorblinded, single case study of a man in MCS 4 years following TBI, zolpidem did not improve ability to follow instructions, and in fact, resulted in slight worsening in performance at some tasks.…”

Section: Zolpidemmentioning

confidence: 80%

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

Chew

Zafonte²

2009

JRRD

161

103

View full text Add to dashboard Cite

Abstract-Pharmacological management of neurobehavioral disorders following traumatic brain injury (TBI) is common practice. However, the evidence available to guide this practice remains sparse. This review summarizes, in brief, the state of knowledge, organized via a time continuum from injury as well as by symptom complex. The areas of neuroprotection, hypoarousal, attention and memory deficits, aggression, agitation, depression, and mania are reviewed. The literature was searched with PubMed on the terms "traumatic brain injury" or "brain injury" with "pharmacology" (and the symptoms according to which this review is arranged). Additional searches were conducted with the specific symptoms as search terms, crossed with the therapeutic agents or drug classes discussed. Where a paucity of prospective data exists, case reports and retrospective studies are included. Studies to date have yielded minimal positive evidence for enhancing function, memory, and behavior after TBI. No single agent likely will become sentinel in the recovery process, and combination therapy in the acute and postacute settings are required. A need exists to further define the role of psychopharmacology in postacute TBI medicine and the specific characteristics of subpopulations who might benefit.

show abstract

Section: Zolpidemmentioning

confidence: 80%

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

Chew

Zafonte²

2009

JRRD

161

103

View full text Add to dashboard Cite

show abstract

“…Zolpidem has therefore only a temporary effect and lasts for a maximum of a few hours. Temporary improvements have since been observed in stroke and near drowning patients , anoxic brain injury (Cohen and Duong 2008), vegetative (Clauss and Nel 2006) and minimally conscious states (BrefelCourbon et al 2007;Shames and Ring 2008). The results varied from a regain of consciousness to an enhancement of motor, verbal and cognitive functions, as well as gestural interaction and arousal.…”

Section: Pharmacologic Treatmentmentioning

confidence: 99%

Disorders of Consciousness: Coma, Vegetative and Minimally Conscious States

Gosseries

Vanhaudenhuyse

Bruno

et al. 2011

The Frontiers Collection

View full text Add to dashboard Cite

Consciousness can be defined by two components: arousal and awareness. Disorders of consciousness (DOC) are characterized by a disrupted relationship between these two components. Coma is described by the absence of arousal and, hence, of awareness whereas the vegetative state is defined by recovery of arousal in the absence of any sign of awareness. In the minimally conscious state, patients show preserved arousal level and exhibit discernible but fluctuating signs of awareness. The study of DOC offers unique insights to the neural correlates of consciousness. We here review the challenges posed by the clinical examination of DOC patients and discuss the contribution of functional neuroimaging and electrophysiological techniques to the bedside assessment of consciousness. These studies raise important issues not only from a clinical and ethical perspective (i.e. diagnosis, prognosis and management of DOC patients) but also from a neuroscientific standpoint, as they enrich our current understanding of the emergence and function of the conscious mind.

show abstract

“…[153][154][155][156][157][158][159][160] Whyte and Myers 157 conducted a placebo-controlled, double-blind, crossover trial in 15 patients who had been in VS or MCS for at least 1 month following traumatic or nontraumatic brain injury. Zolpidem (10 mg) or placebo was administered in blinded order on two different occasions, separated by 1-7 days.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

Disorders of consciousness after acquired brain injury: the state of the science

et al. 2014

View full text Add to dashboard Cite

| The concept of consciousness continues to defy definition and elude the grasp of philosophical and scientific efforts to formulate a testable construct that maps to human experience. Severe acquired brain injury results in the dissolution of consciousness, providing a natural model from which key insights about consciousness may be drawn. In the clinical setting, neurologists and neurorehabilitation specialists are called on to discern the level of consciousness in patients who are unable to communicate through word or gesture, and to project outcomes and recommend approaches to treatment. Standards of care are not available to guide clinical decision-making for this population, often leading to inconsistent, inaccurate and inappropriate care. In this Review, we describe the state of the science with regard to clinical management of patients with prolonged disorders of consciousness. We review consciousness-altering pathophysiological mechanisms, specific clinical syndromes, and novel diagnostic and prognostic applications of advanced neuroimaging and electrophysiological procedures. We conclude with a provocative discussion of bioethical and medicolegal issues that are unique to this population and have a profound impact on care, as well as raising questions of broad societal interest.

show abstract

Increased Arousal in a Patient with Anoxic Brain Injury After Administration of Zolpidem

Cited by 55 publications

References 7 publications

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

Disorders of Consciousness: Coma, Vegetative and Minimally Conscious States

Disorders of consciousness after acquired brain injury: the state of the science

Contact Info

Product

Resources

About