Novel use of zolpidem in cerebellar mutism syndrome

Cerebellar mutism syndrome (CMS) is a complication of posterior fossa surgery seen primarily in pediatric patients after resection of medulloblastoma. CMS is characterized by mutism, ataxia, hypotonia, and irritability. Currently, there is no therapy of proven efficacy. Zolpidem, although primarily used as a sedative, has been shown to alleviate mutism and promote arousal in similar neurologic and psychiatric disorders. Here, we describe a child with severe CMS in whom zolpidem seemed to increase arousal, accelerate the resolution of mutism, and decrease emotional lability. Our report suggests that clinicians should consider using zolpidem for patients with CMS.