Toronto-A Dutch man who has been unable to move or talk for eight years due to a serious brain injury has temporarily started chatting with his family after being given sleeping pills. Case report..
According to doctors, a 37-year-old man was identified only by his name in the report, and Richard was first hospitalized at the age of 29 due to a severe oxygen deficiency caused by choking on a piece of meat.
After a slow recovery, doctors noticed that Richard was less responsive. He appeared to be awake, but showed no reaction or voluntary movement, and made no effort to eat or drink.
He was later transferred to a nursing home without a formal diagnosis explaining his condition. Eight years have passed without any improvement, according to a research report on the condition of men.
Eventually, a new nursing home doctor with experience with hyporesponsiveness took over the treatment of the man and performed a neurological examination to determine the type of care he needed.
“It was clear that Richard saw and heard us,” Willemin van Elp, an elderly care physician and researcher at Radboud University Medical Center, said in a statement. “But because of his brain injury, he could hardly react to us.”
As a result of the evaluation, the patient showed “complete lack of voluntary movement (kinesia) and lack of speech (akinetic mutism)”. Richard was tied to a wheelchair and “was completely dependent on long-term care for all daily activities, including the need for enteral nutrition,” the report said.
After consulting with his family, nursing home doctors gave a single dose of zolpidem, which is primarily used for short-term treatment of sleep disorders. Among other things, it is sold under the brand name Ambien.
According to the report, “Within 20 minutes, the patient began to communicate voluntarily, asked the nurse how to operate the wheelchair, and demanded fast food. He managed to walk with the support of the staff and his son’s I called my father, who hadn’t heard his voice for years. “
Doctors said the man was cheerful and alert, despite the recurrence of retrograde amnesia three years before the brain injury. However, two hours after taking Zolpidem, Richard gradually returned to a demoralized state.
When doctors noticed the man’s reaction to the drug, the nursing home began giving him a regiment of drugs taking zolpidem three times a day before and after a meal, but a few days later he began to notice a serious decline in the effectiveness of the drug. I did.
Over time, the time frame in which men can talk and move has narrowed, and their abilities during that time have diminished. Doctors then tried multiple doses during the day, but the man’s condition did not improve, sometimes even causing sedation.
They found that it usually took two to two weeks without medication to notice the effects of a single dose of zolpidem. As a result, medication was restricted to special occasions such as family visits and dentist appointments.
With this new drug therapy, a single dose of zolpidem could cause the same effects observed after the first dose of the drug, lasting about an hour.
“Richard’s brain scan shows overactivity in certain parts of the brain. This overactivity causes noise and somehow shuts down’good brain activity’,” said the resident neurosurgeon at the University of Amsterdam Medical Center. Said the surgeon Hisse Ernto. The drug can suppress this unwanted brain overactivity and create space for conversation and movement. “
Despite the positive effects of zolpidem, researchers continue to look for more permanent solutions for patients with Richard and other severe neurological problems.
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