title: Clinically significant response to zolpidem in disorders of consciousness secondary to anti-N-methyl-D-aspartate receptor encephalitis in a teenager: a case report.
abstract: BACKGROUND
  Anti-N-methyl-d-aspartate receptor encephalitis has been associated with a prolonged neuropsychiatric phase that may last for months to years.
  
  
  METHODS
  We report the case of a 16-year-old girl who was diagnosed with anti-N-methyl-d-aspartate receptor encephalitis resulting from left ovarian mature teratoma 2 weeks after presentation with psychosis. Following tumor removal and immunotherapy, recovery from a minimally conscious state was accelerated significantly by zolpidem that was used for her sleep disturbance. Our patient was discharged home 8 weeks after admission with marked improvement in her neurological function. Zolpidem has been reported to improve arousal in disorders of consciousness but there are no previous reports of its benefit among patients with anti-N-methyl-d-aspartate receptor encephalitis.
  
  
  CONCLUSIONS
  Zolpidem would be a reasonable consideration as an adjunctive treatment in anti-N-methyl-d-aspartate receptor encephalitis after tumor removal and immunotherapy to accelerate recovery and rehabilitation.
authors.affiliation: Department of Neurology, Division of Pediatric and Developmental Neurology, Washington University in St. Louis, St. Louis, Missouri. Electronic address: merveenappu@yahoo.com.
authors.forename: Merveen
authors.initials: M
authors.lastname: Appu
authors.affiliation: Department of Neurology, Division of Pediatric and Developmental Neurology, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Michael
authors.initials: M
authors.lastname: Noetzel
mesh_terms: D000293:Adolescent; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000150:complications* / Q000601:surgery / Q000628:therapy; D002491:Central Nervous System Agents / Q000627:therapeutic use*; D003244:Consciousness Disorders / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007167:Immunotherapy; D011725:Pyridines / Q000627:therapeutic use*; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D000077334:Zolpidem
chemical_list: D002491:Central Nervous System Agents; D011725:Pyridines; D000077334:Zolpidem
keywords: anti-N-methyl-d-aspartate receptor encephalitis; disorders of consciousness; minimally conscious state; neurorehabilitation; zolpidem